Relationship between total bilirubin and endothelial function, inflammation and oxidative stress in HIV‐infected adults on stable antiretroviral therapy

Objectives Enhanced inflammation is evident in HIV infection, even with virological suppression. Outside HIV infection, studies show an independent association between higher total bilirubin and better endothelial function as well as a lower prevalence of coronary heart disease, possibly as a conseq...

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Bibliographic Details
Published in:HIV medicine 2012-11, Vol.13 (10), p.609-616
Main Authors: Hileman, CO, Longenecker, CT, Carman, TL, Milne, GL, Labbato, DE, Storer, NJ, White, CA, McComsey, GA
Format: Article
Language:English
Subjects:
Adult
Antioxidants
antiretroviral therapy
Arteries
Atazanavir Sulfate
Bilirubin
Bilirubin - blood
biomarkers
Blood Flow Velocity
Brachial Artery - physiopathology
C-reactive protein
C-Reactive Protein - metabolism
Cell Adhesion Molecules - blood
Coagulation
Coronary heart disease
Cross-Sectional Studies
endothelial function
Endothelium, Vascular - drug effects
Endothelium, Vascular - physiopathology
F2-Isoprostanes - blood
Female
Fibrin Fibrinogen Degradation Products - metabolism
Fibrinogen
Fibrinogen - metabolism
HIV infection
HIV Protease Inhibitors - pharmacology
HIV Seropositivity - blood
HIV Seropositivity - drug therapy
HIV Seropositivity - physiopathology
Homeostasis
Human immunodeficiency virus
Humans
Infection
Inflammation
Inflammation - blood
Insulin
Interleukin 6
Interleukin-6 - blood
Male
Middle Aged
Oligopeptides - pharmacology
Oxidative stress
Oxidative Stress - drug effects
Pyridines - pharmacology
Regression analysis
Retrospective Studies
total bilirubin
Tumor necrosis factor receptors
Tumor Necrosis Factor-alpha - blood
Vasodilation
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Summary:Objectives Enhanced inflammation is evident in HIV infection, even with virological suppression. Outside HIV infection, studies show an independent association between higher total bilirubin and better endothelial function as well as a lower prevalence of coronary heart disease, possibly as a consequence of the anti‐inflammatory and antioxidant effect of bilirubin. The aim of this study was to determine whether such an association exists in HIV‐infected individuals. Methods A cross‐sectional study was performed in HIV‐1‐infected adults on stable antiretroviral therapy (ART) to determine if a relationship exists between total bilirubin and endothelial function [flow‐mediated dilation (FMD) of the brachial artery], inflammation [interleukin‐6 (IL‐6), soluble tumour necrosis factor receptors, C‐reactive protein, and adhesion molecules], coagulation markers (fibrinogen and D‐dimer) and oxidative stress (F 2‐isoprostanes). Endpoints were compared based on total bilirubin levels and atazanavir status using distributionally appropriate, two‐sample tests. Correlation coefficients were determined between total bilirubin and endpoints. Linear regression was used to model the relationship between total bilirubin (and atazanavir status) and FMD. Results A total of 98 adults were included in the study. Total bilirubin was higher in the atazanavir group when compared to the non‐atazanavir group [median (interquartile range) 1.8 (1.1–2.6) vs. 0.6 (0.4–1.4) mg/dL; P 
ISSN:1464-2662
1468-1293
DOI:10.1111/j.1468-1293.2012.01026.x