Relationship between inflammatory markers, endothelial activation markers, and carotid intima-media thickness in HIV-infected patients receiving antiretroviral therapy.
BACKGROUND
Human immunodeficiency virus (HIV)-infected patients are at increased risk of cardiovascular disease, which may be related to chronic inflammation and endothelial dysfunction despite virological control with antiretroviral therapy. The relationship between carotid intima-media thickness (IMT), a surrogate marker for cardiovascular disease, proinflammatory cytokines, and endothelial activation markers has not been fully explored in HIV-infected patients who are receiving antiretroviral therapy.


METHODS
We conducted a prospective, cross-sectional, observational study of treated HIV-infected patients and healthy control subjects to evaluate the relationship between carotid IMT, proinflammatory cytokines, endothelial activation biomarkers, and metabolic parameters in treated HIV-infected patients, compared with healthy control subjects.


RESULTS
We enrolled 73 HIV-infected patients and 21 control subjects. Common carotid artery and internal carotid artery IMT measurements, as well as tumor necrosis factor-alpha, high-sensitivity C-reactive protein, interleukin-6, myeloperoxidase, and soluble vascular cell adhesion molecule-1 levels were higher in the HIV-infected group. High-sensitivity C-reactive protein was the only biomarker that was positively correlated with carotid IMT in both groups. In the HIV-infected group, soluble vascular cell adhesion molecule-1 was positively correlated with all inflammatory cytokine levels. In multiple regression analysis, soluble vascular cell adhesion molecule-1, myeloperoxidase, and tumor necrosis factor-alpha levels were all associated with internal carotid artery IMT in the HIV-infected group, whereas age was associated with both common carotid artery and internal carotid artery IMT.


CONCLUSIONS
Enhanced endothelial activation, inflammation, and increased carotid IMT occur in HIV-infected patients despite antiretroviral therapy. Inflammatory markers are associated with endothelial activation, and both are associated with internal carotid artery IMT, supporting a potential role of inflammation in endothelial activation and cardiovascular disease in HIV infection.
Ross
Allison C
AC
Rainbow Babies and Children's Hospital, 11100 Euclid Ave, Cleveland, OH 44106, USA.
Rizk
Nesrine
N
O'Riordan
Mary Ann
MA
Dogra
Vikram
V
El-Bejjani
Dalia
D
Storer
Norma
N
Harrill
Danielle
D
Tungsiripat
Marisa
M
Adell
Jerome
J
McComsey
Grace A
GA
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology*; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D009195:Peroxidase / Q000097:blood; D011446:Prospective Studies; D017539:Tunica Intima / Q000473:pathology*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D019380:Anti-HIV Agents; D016207:Cytokines; D019010:Vascular Cell Adhesion Molecule-1; D002097:C-Reactive Protein; D009195:Peroxidase