High-sensitivity C-reactive protein levels in HIV-infected patients treated or not with antiretroviral drugs and their correlation with factors related to cardiovascular risk and HIV infection.
OBJECTIVE
To compare high-sensitivity C-reactive protein (hsCRP) in HIV-infected patients treated or not with antiretroviral (ARV) drugs and to correlate hsCRP levels with traditional cardiovascular risk factors and parameters of HIV infection.


METHODS
One hundred and seventy-one HIV-infected patients were included (129 ARV-treated and 42 ARV-naïve). Evaluations included anthropometric measurements, blood pressure, laboratory tests, ultrasonographic measurement of fat thickness and impedance analysis.


RESULTS
hsCRP levels were higher in ARV-treated compared to ARV-naïve patients (p<0.001). Seventy-two (56%) ARV-treated patients and 11 (26%) ARV-naïve patients had hsCRP concentrations >3 mg/dl (high risk for cardiovascular complications) (OR 3.56; 95%CI: 1.55-8.29; p=0.001, chi(2) test). hsCRP levels correlated positively with waist measurement (p=0.004), waist-to-hip ratio (p<0.001), systolic (p=0.05) and diastolic (p=0.03) blood pressure, intra-abdominal fat thickness (p=0.02), triglycerides (p=0.001), total cholesterol (p=0.01), fasting glucose (p=0.01), and glucose (p<0.001) and insulin levels (p=0.02) measured 2 h after load. No correlation was found between hsCRP levels and CD4 cell counts and HIV-viral load. Independent factors associated with hsCRP levels were therapy with current non-nucleoside reverse transcriptase inhibitors (NNRTI) (p=0.003), waist-to-hip ratio (p=0.006), fasting glucose (p=0.049) and glucose levels 2 h after load (p=0.003) in multivariate analysis model 1 and current NNRTI therapy (p<0.001), protease inhibitor therapy (p=0.016) and cardiometabolic syndrome (p=0.022) in multivariate analysis model 2.


CONCLUSIONS
hsCRP in HIV-infected patients is associated with traditional cardiovascular risk factors, principally in ARV-treated patients. hsCRP levels are not associated with CD4 cell counts and HIV-viral load and may constitute a marker for cardiovascular risk related to HIV infection and ARV therapy.
Guimarães
Milena Maria Moreira
MM
Universidade Federal de Minas Gerais, Laboratórios 3063 e 3065, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil. milenamg@uol.com.br
Greco
Dirceu Bartolomeu
DB
Figueiredo
Sônia Maria de
SM
Fóscolo
Rodrigo Bastos
RB
Oliveira
Antônio Ribeiro de
AR
Machado
Lucas José de Campos
LJ
D050154:Adiposity; D000328:Adult; D000886:Anthropometry / Q000379:methods; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000096:biosynthesis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis; D008875:Middle Aged; D012307:Risk Factors; D012680:Sensitivity and Specificity
D044966:Anti-Retroviral Agents; D002097:C-Reactive Protein