Association of biomarkers with atherosclerosis and risk for coronary artery disease in patients with HIV.
BACKGROUND
The massive use of Highly-Active Antiretroviral Therapy (HAART) in individuals with human immunodeficiency virus (HIV) coincided with an increase in cardiovascular disease, a major cause of morbidity and mortality in this group.


OBJECTIVE
To determine the frequency of carotid atherosclerosis and the association between biomarker levels and carotid intimal-medial thickening in HIV-positive individuals treated for HIV at referral centers in Pernambuco.


METHODS
This was a cross-sectional study of 122 HIV-positive patients. Subclinical carotid atherosclerosis was considered with the presence of increased intimal-medial thickness of the common carotid artery > 0.8 mm or plaques in the carotid ultrasound. The following inflammatory biomarkers were analyzed: IL6, IL1-β, TNF-α, high-sensitivity CRP, sVCAM-1 and sICAM-1.


RESULTS
Of the 122 patients analyzed, most were men (60.7%) aged > 40 years (57.4%) receiving HAART (81.1%). The prevalence of atherosclerosis was 42.6% (52 cases). Patients older than 40 years and intermediate or high Framingham score were more likely to develop atherosclerosis at the univariate analysis. Age older than 40 years (OR = 6.57, 95%CI: 2.66 to 16.2, p = 0.000), male gender (OR = 2.76, 95%CI: 1.12 to 6.79, p = 0.027) and presence of syndrome metabolic (OR = 2.27, 95%CI: 0.94 to 5.50, p = 0.070) were associated with atherosclerosis at the multivariate analysis. Elevated levels of inflammatory cytokines and adhesion molecules were not associated with the presence of atherosclerosis.


CONCLUSIONS
There was no association between inflammatory biomarkers, adhesion molecules and presence of carotid atherosclerosis. However, a higher chance of subclinical atherosclerosis was observed in men, those older than 40 years, with intermediate / high Framingham score or metabolic syndrome.
Universidade Federal de Pernambuco, Recife, PE, Brasil.
Maria da Conceição Brandão de Arruda
Mda C
Falcão
Josefina Cláudia
JC
Zírpoli
Valéria Maria de
VM
Albuquerque
Brivaldo
B
Markman Filho
Nelson Antônio Moura de
NA
Araújo
Creso Abreu
CA
Falcão
Demócrito de Barros
Dde B
Miranda-Filho
Ricardo Alencar de Arraes
RA
Ximenes
Maria de Fátima Militão de
Mde F
Albuquerque
Heloísa Ramos
HR
Lacerda
D000328:Adult; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002340:Carotid Artery Diseases / Q000097:blood* / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000097:blood* / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006678:HIV / Q000378:metabolism*; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D012307:Risk Factors; D017678:Sex Distribution
D015415:Biomarkers