Elevated NT-pro-BNP levels are associated with comorbidities among HIV-infected women.
HIV infection is associated with left ventricular (LV) dysfunction and accelerated atherosclerosis. These conditions result in elevation of plasma natriuretic peptide (NP) levels. The present study compares N-terminal-pro-BNP (NT-pro-BNP) levels in HIV-infected and -uninfected women and identifies factors influencing NT-pro-BNP levels in HIV-infected women. A total of 454 HIV-infected and 200 HIV-uninfected participants from the Women's Interagency HIV Study (WIHS) had NT-pro-BNP determination. Elevated NT-pro-BNP level was defined using previously determined age stratified cut-off values of >164 ng/liter (age <60 years) and >225 (age > or = 60 years). HIV-infected women were older (41.6 +/- 8.9 vs. 38.9 +/- 10.5 years, p < 0.01) and were more likely to have anemia, hepatitis C virus (HCV) antibodies, and kidney dysfunction than HIV-uninfected women. HIV-infected women had significantly higher NT-pro-BNP levels (142.4 +/- 524.8 vs. 73.6 +/- 115.1 ng/liter, p = 0.01) and a higher prevalence of elevated NT-pro-BNP (12.1% vs. 7.5%; p = 0.08). In univariate analyses, elevated NT-pro-BNP was significantly associated with age, systolic BP, hypertension, anemia, triglyceride levels, kidney disease, and HCV seropositivity, but not HIV infection. In multivariate analysis, elevated NT-pro-BNP levels were significantly associated with anemia and kidney function, and had a borderline association with the presence of HCV antibodies. Among HIV-infected women, NT-pro-BNP levels were not independently associated with measures of severity of infection or with HAART use. Although HIV-infected women have higher NT-pro-BNP levels than HIV-uninfected women, the differences are due to non-HIV factors such as anemia, kidney disease, and HCV coinfection. These findings suggest that natriuretic peptide levels are a global marker of comorbidity in the setting of HIV infection.
Mansoor
Ather
A
Division of Cardiology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
Althoff
Keri
K
Gange
Stephen
S
Anastos
Kathryn
K
Dehovitz
Jack
J
Minkoff
Howard
H
Kaplan
Robert
R
Holman
Susan
S
Lazar
Jason M
JM
D000328:Adult; D000740:Anemia / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*; D006526:Hepatitis C / Q000503:physiopathology; D006801:Humans; D007674:Kidney Diseases / Q000503:physiopathology; D008875:Middle Aged; D045265:Natriuretic Peptides / Q000097:blood*
D045265:Natriuretic Peptides