Relationship between Inflammatory Markers, Endothelial Activation Markers, and Carotid Intima-Media Thickness in HIV-Infected Patients Receiving Antiretroviral Therapy

Background.Human immunodeficiency virus (HIV)-infected patients are at increased risk of cardiovascular disease, which may be related to chronic inflammation and endothelial dysfunction despite virological control with antiretroviral therapy. The relationship between carotid intima-media thickness (...

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Bibliographic Details
Published in:Clinical infectious diseases 2009-10, Vol.49 (7), p.1119-1127
Main Authors: Ross, Allison C., Rizk, Nesrine, O'Riordan, Mary Ann, Dogra, Vikram, El-Bejjani, Dalia, Storer, Norma, Harrill, Danielle, Tungsiripat, Marisa, Adell, Jerome, McComsey, Grace A.
Format: Article
Language:English
Subjects:
Anti-HIV Agents - therapeutic use
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiretroviral drugs
Antiretroviral Therapy, Highly Active
Antiretrovirals
Antiviral agents
Biological and medical sciences
Biological markers
Biomarkers
Body mass index
C-Reactive Protein - analysis
Cardiovascular disease
Cardiovascular Diseases - pathology
Carotid Arteries - pathology
Cross-Sectional Studies
Cytokines - blood
Disease risk
Drug therapy
HDL lipoproteins
HIV
HIV infections
HIV Infections - complications
HIV Infections - drug therapy
HIV/AIDS
Human immunodeficiency virus
Human viral diseases
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infections
Infectious diseases
Medical sciences
Medications
Necrosis
Peroxidase - blood
Pharmacology. Drug treatments
Prospective Studies
Risk factors
Tumors
Tunica Intima - pathology
Vascular Cell Adhesion Molecule-1 - blood
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:Background.Human immunodeficiency virus (HIV)-infected patients are at increased risk of cardiovascular disease, which may be related to chronic inflammation and endothelial dysfunction despite virological control with antiretroviral therapy. The relationship between carotid intima-media thickness (IMT), a surrogate marker for cardiovascular disease, proinflammatory cytokines, and endothelial activation markers has not been fully explored in HIV-infected patients who are receiving antiretroviral therapy. Methods.We conducted a prospective, cross-sectional, observational study of treated HIV-infected patients and healthy control subjects to evaluate the relationship between carotid IMT, proinflammatory cytokines, endothelial activation biomarkers, and metabolic parameters in treated HIV-infected patients, compared with healthy control subjects. Results.We enrolled 73 HIV-infected patients and 21 control subjects. Common carotid artery and internal carotid artery IMT measurements, as well as tumor necrosis factor-α, high-sensitivity C-reactive protein, interleukin-6, myeloperoxidase, and soluble vascular cell adhesion molecule-1 levels were higher in the HIV-infected group. High-sensitivity C-reactive protein was the only biomarker that was positively correlated with carotid IMT in both groups. In the HIV-infected group, soluble vascular cell adhesion molecule-1 was positively correlated with all inflammatory cytokine levels. In multiple regression analysis, soluble vascular cell adhesion molecule-1, myeloperoxidase, and tumor necrosis factor-α levels were all associated with internal carotid artery IMT in the HIV-infected group, whereas age was associated with both common carotid artery and internal carotid artery IMT. Conclusions.Enhanced endothelial activation, inflammation, and increased carotid IMT occur in HIV-infected patients despite antiretroviral therapy. Inflammatory markers are associated with endothelial activation, and both are associated with internal carotid artery IMT, supporting a potential role of inflammation in endothelial activation and cardiovascular disease in HIV infection.
ISSN:1058-4838
1537-6591
DOI:10.1086/605578