Sex Differences in Subclinical Atherosclerosis and Systemic Immune Activation/Inflammation Among People With Human Immunodeficiency Virus in the United States.

Autor:	Zanni MV; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Foldyna B; Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., McCallum S; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Burdo TH; Department of Microbiology, Immunology, and Inflammation and Center for NeuroVirology and Gene Editing, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA., Looby SE; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.; Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Fitch KV; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Fulda ES; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Autissier P; Department of Biology , Boston College, Chestnut Hill, Massachusetts, USA., Bloomfield GS; Department of Medicine, Duke Global Health Institute and Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA., Malvestutto CD; Division of Infectious Diseases, Ohio State University Medical Center, Columbus, Ohio, USA., Fichtenbaum CJ; Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Overton ET; Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA., Aberg JA; Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Erlandson KM; Department of Medicine, Division of Infectious Disease, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA., Campbell TB; Department of Medicine, Division of Infectious Disease, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA., Ellsworth GB; Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA., Sheth AN; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Taiwo B; Division of Infectious Diseases and Center for Global Health, Northwestern University, Chicago, Illinois, USA., Currier JS; Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA., Hoffmann U; Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Lu MT; Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Douglas PS; Duke University Research Institute, Duke University School of Medicine, Durham, North Carolina, USA., Ribaudo HJ; Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA., Grinspoon SK; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 Jan 13; Vol. 76 (2), pp. 323-334.
DOI:	10.1093/cid/ciac767
Abstrakt:	Background: Among people with HIV (PWH), sex differences in presentations of atherosclerotic cardiovascular disease (ASCVD) may be influenced by differences in coronary plaque parameters, immune/inflammatory biomarkers, or relationships therein. Methods: REPRIEVE, a primary ASCVD prevention trial, enrolled antiretroviral therapy (ART)-treated PWH. At entry, a subset of US participants underwent coronary computed tomography angiography (CTA) and immune phenotyping (n = 755 CTA; n = 725 CTA + immune). We characterized sex differences in coronary plaque and immune/inflammatory biomarkers and compared immune-plaque relationships by sex. Unless noted otherwise, analyses adjust for ASCVD risk score. Results: The primary analysis cohort included 631 males and 124 females. ASCVD risk was higher among males (median: 4.9% vs 2.1%), while obesity rates were higher among females (48% vs 21%). Prevalence of any plaque and of plaque with either ≥1 visible noncalcified portion or vulnerable features (NC/V-P) was lower among females overall and controlling for relevant risk factors (RR [95% CI] for any plaque: .67 [.50, .92]; RR for NC/V-P: .71 [.51, 1.00] [adjusted for ASCVD risk score and body mass index]). Females showed higher levels of IL-6, hs-CRP, and D-dimer and lower levels of Lp-PLA2 (P < .001 for all). Higher levels of Lp-PLA2, MCP-1, and oxLDL were associated with higher plaque (P < .02) and NC/V-P prevalence, with no differences by sex. Among females but not males, D-dimer was associated with higher prevalence of NC/V-P (interaction P = .055). Conclusions: Among US PWH, females had a lower prevalence of plaque and NC/V-P, as well as differences in key immune/inflammatory biomarkers. Immune-plaque relationships differed by sex for D-dimer but not other tested parameters. Clinical Trial Registration. ClinicalTrials.gov; identifier: NCT0234429 (date of initial registration: 22 January 2015). (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze:	MEDLINE
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