title: The association of high-sensitivity c-reactive protein and other biomarkers with cardiovascular disease in patients treated for HIV: a nested case-control study.
abstract: BACKGROUND
  Elevated high-sensitivity C-reactive protein (hsCRP) increases the risk of cardiovascular disease (CVD) in the general population, but its role as a predictive marker in HIV-positive patients remains unclear. Aim of the study was to evaluate whether hsCRP or other biomarkers are independent predictors of CVD risk in HIV-infected patients.
  
  
  METHODS
  Retrospective, nested case-control study. HIV-positive men and women (35-69 years of age) receiving combination antiretroviral therapy (cART) were included. Cases (n = 35) had a major CVD event. Controls (n = 74) free from CVD events for at least 5 years from starting ART were matched on diabetes and smoking. HsCRP, D-dimer, P-selectin, interleukin-6 (IL-6), tissue plasminogen activator, plasminogen activator inhibitor-1 levels were measured.
  
  
  RESULTS
  High hsCRP was associated with CVD risk, independently of traditional cardiovascular risk factors, HIV replication and the type of ART received at the time of sampling (adjusted odds ratio 8.00 [1.23-51.94] comparing >3.3 mg/L with <0.9 mg/L; P = 0.03). Higher IL-6 and P-selectin levels were also independently associated with increased CVD risk, although the association was weaker than for hsCRP. Higher total cholesterol and lower HDL cholesterol increased CVD risk, independent of hsCRP.
  
  
  CONCLUSIONS
  hsCRP may be a useful additional biomarker to predict CVD risk in HIV-infected patients receiving cART.
authors.affiliation: University Division of Infectious Diseases, University Hospital of Siena, Siena, Italy. deluca.andrea@fastwebnet.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: De Luca
authors.forename: Katleen
authors.initials: K
authors.lastname: de Gaetano Donati
authors.forename: Manuela
authors.initials: M
authors.lastname: Colafigli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cozzi-Lepri
authors.forename: Amalia
authors.initials: A
authors.lastname: De Curtis
authors.forename: Andrea
authors.initials: A
authors.lastname: Gori
authors.forename: Laura
authors.initials: L
authors.lastname: Sighinolfi
authors.forename: Andrea
authors.initials: A
authors.lastname: Giacometti
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Capobianchi
authors.forename: Alessandro
authors.initials: A
authors.lastname: D'Avino
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
authors.forename: Roberto
authors.initials: R
authors.lastname: Cauda
authors.forename: Antonella
authors.initials: A
authors.lastname: D'Arminio Monforte
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein