title: C-reactive protein as a predictor of cardiovascular risk in HIV-infected individuals.
abstract: Background In some studies HIV infection confers approximately two-fold higher risk of cardiac events compared with the general population. C-reactive protein (CRP) is a well-characterised biomarker of cardiac events in the general population and is also elevated in patients with HIV infection. The aim of this study was to determine the predictive value of CRP for cardiac events in HIV-infected individuals.
  
  
  METHODS
  We retrospectively analysed CRP levels in stored plasma samples from HIV-infected patients who did or did not experience a coronary event in a case-controlled manner. All CRP measurements were performed using a high-sensitivity assay (hs-CRP).
  
  
  RESULTS
  Of the study participants with samples available, we found slightly elevated hs-CRP levels in the cardiac cases (median 3.5, IQR 1.6-14.4, n=23) compared with controls (median 2.6, IQR1.2-8.3, n=49) which were shown to not be statistically significant P=0.20. Analysis of CRP as a binary variable (≥5mgL(-1)) was also not statistically significant (OR: 1.32, 95% CI 0.48-3.63).
  
  
  CONCLUSIONS
  CRP levels may indicate elevated risk of future cardiac events, however this must be interpreted with caution due to the generalised elevation of CRP during HIV infection. CRP has no predictive value for atherosclerosis, and further research is required to improve early prediction of cardiovascular disease in HIV infection.
authors.affiliation: Macfarlane Burnet Institute for Medical Research and Public Health, Prahran, Vic. 3004, Australia.
authors.forename: Clare L V
authors.initials: CL
authors.lastname: Westhorpe
authors.affiliation: Alfred Pathology Service, Alfred Health, Commercial Road, Prahran, Vic. 3004, Australia.
authors.forename: Hans G
authors.initials: HG
authors.lastname: Schneider
authors.affiliation: Macfarlane Burnet Institute for Medical Research and Public Health, Prahran, Vic. 3004, Australia.
authors.forename: Mandy
authors.initials: M
authors.lastname: Dunne
authors.affiliation: Victorian Infectious Diseases Reference Laboratory, Wreckyn Street, North Melbourne, Vic. 3051, Australia.
authors.forename: Tracey
authors.initials: T
authors.lastname: Middleton
authors.affiliation: Department of Human Services Victoria, Lonsdale Street, Melbourne, Vic. 3000, Australia.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Sundararajan
authors.affiliation: Macfarlane Burnet Institute for Medical Research and Public Health, Prahran, Vic. 3004, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Spelman
authors.affiliation: Department of Nutrition, The Alfred Hospital, Commercial Road, Prahran, Vic. 3004, Australia.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Carter
authors.affiliation: Macfarlane Burnet Institute for Medical Research and Public Health, Prahran, Vic. 3004, Australia.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Crowe
authors.affiliation: Department of Cardiology, The Alfred Hospital, Commercial Road, Prahran, Vic. 3004, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Dart
authors.affiliation: Department of Medicine, Central and Eastern Clinical School, Monash University, Melbourne, Vic. 3004, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Mijch
authors.affiliation: Department of Infectious Diseases, Monash Health, Clayton Road, Clayton, Vic. 3168, Australia.
authors.forename: Despina
authors.initials: D
authors.lastname: Kotsanas
authors.affiliation: Department of Medicine, Central and Eastern Clinical School, Monash University, Melbourne, Vic. 3004, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Woolley