title: Association of residual plasma viremia and intima-media thickness in antiretroviral-treated patients with controlled human immunodeficiency virus infection.
abstract: BACKGROUND
  While residual plasma viremia is commonly observed in HIV-infected patients undergoing antiretroviral treatment (ART), little is known about its subclinical consequences.
  
  
  METHODS
  This cross-sectional study included 47 male, never-smoking, non-diabetic patients with ≥4 years of ART and controlled HIV-replication (HIV-viral load, VL <20 copies/mL for ≥1 year). Residual HIV-VL was measured using an ultrasensitive assay (quantification limit: 1 copy/ml). Patients were categorized as having detectable (D; 1-20 copies/mL, n = 14) or undetectable (UD; <1 copies/mL, n = 33) HIV-VL. Linear regression was used to model the difference in total carotid intima-media thickness [c-IMT, measures averaged across common carotid artery (cca), bifurcation, and internal carotid artery] and cca-IMT alone across detection groups. Multivariable models were constructed for each endpoint in a forward-stepwise approach.
  
  
  RESULTS
  No significant differences were observed between viremia groups with respect to median ART-duration (9.6 years, IQR = 6.8-10.9), nadir CD4+T-cell (208/mm3, IQR = 143-378), and CD4+T-cell count (555/mm3, IQR = 458-707). Median adjusted inflammatory markers tended to be higher in patients with D- than UD-viremia, with differences in IL-10 being significant (p = 0.03). After adjustment on age, systolic blood pressure, and insulin resistance, mean cca-IMT was significantly lower in patients with undetectable (0.668 mm±0.010) versus detectable viremia (0.727 mm±0.015, p = 0.002). Cca-IMT was also independently associated with age and insulin resistance. Mean adjusted total c-IMT was no different between viremia groups (p = 0.2), however there was large variability in bifurcation c-IMT measurements.
  
  
  CONCLUSIONS
  Higher cca-IMT was observed in patients with detectable, compared to undetectable, HIV-VL in never-smoking ART-controlled patients, suggesting that residual HIV viremia may be linked to atherosclerosis.
authors.affiliation: INSERM UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
authors.forename: Anders
authors.initials: A
authors.lastname: Boyd
authors.affiliation: Sorbonne Université, UPMC Univ Paris-6, Paris, France; Department of Infectious and Tropical Diseases, Hôpital Saint-Antoine, AP-HP, Paris, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Meynard
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Laboratoire de Virologie, Saint Antoine, APHP, Paris, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Morand-Joubert
authors.affiliation: Service de médecine interne, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Michon
authors.affiliation: Sorbonne Université, UPMC Univ Paris-6, Paris, France; Department of Cardiology, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM UMR_S 938, Paris, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Boccara
authors.affiliation: Sorbonne Université, UPMC Univ Paris-6, Paris, France; APHP, Hôpital Tenon, Service de biochimie et hormonologie, Inserm UMR_S938, and Institute of Cardiometabolism and Nutrition, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Bastard
authors.affiliation: Sorbonne Université, UPMC Univ Paris-6, Paris, France; Inserm, UMR-S945, IFR113, Department of Immunology, Paris, France.
authors.forename: Assia
authors.initials: A
authors.lastname: Samri
authors.affiliation: Sorbonne Université, UPMC Univ Paris-6, Paris, France; Department of Cardiology, Hôpital Saint-Antoine, AP-HP, Paris, France.
authors.forename: Nabila
authors.initials: N
authors.lastname: Haddour
authors.affiliation: Inserm U970, Cardiovascular Research Center, and Université Paris-Descartes University, Paris, France; Department of Medicine, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Mallat
authors.affiliation: Sorbonne Université, UPMC Univ Paris-6, Paris, France; APHP, Hôpital Tenon, Service de biochimie et hormonologie, Inserm UMR_S938, and Institute of Cardiometabolism and Nutrition, Paris, France.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Capeau
authors.affiliation: Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, United States of America; Inserm U738 and Ecole des Hautes Études en Santé Publique, Paris, France.
authors.forename: Moïse
authors.initials: M
authors.lastname: Desvarieux
authors.affiliation: INSERM UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Sorbonne Université, UPMC Univ Paris-6, Paris, France; Department of Infectious and Tropical Diseases, Hôpital Saint-Antoine, AP-HP, Paris, France.
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Girard
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D050197:Atherosclerosis / Q000097:blood / Q000473:pathology / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000473:pathology / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D014766:Viremia / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology
chemical_list: D044966:Anti-Retroviral Agents