Potential Cardiovascular Disease Risk Markers Among HIV-Infected Women Initiating Antiretroviral Treatment
| Autor: | Mary Young, Robert C. Kaplan, Russell P. Tracy, Philip J. Norris, Howard N. Hodis, Xiaonan Xue, Lorie Benning, Stephen J. Gange, Jason Lazar, Kathryn Anastos, Phyllis C. Tien, Christina M. Parrinello, Alan L. Landay |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
medicine.medical_specialty CD14 HIV Infections Inflammation Fibrinogen Gastroenterology Article Fibrin Fibrinogen Degradation Products Internal medicine Prevalence Humans Medicine Pharmacology (medical) Ultrasonography business.industry virus diseases Interleukin Atherosclerosis Tunica intima Carotid Arteries Infectious Diseases medicine.anatomical_structure Anti-Retroviral Agents Hemostasis Immunology Cytokines Biomarker (medicine) Female Tumor necrosis factor alpha medicine.symptom Tunica Intima business Biomarkers medicine.drug |
| Zdroj: | JAIDS Journal of Acquired Immune Deficiency Syndromes. 60:359-368 |
| ISSN: | 1525-4135 |
| Popis: | BACKGROUND Inflammation and hemostasis perturbation may be involved in vascular complications of HIV infection. We examined atherogenic biomarkers and subclinical atherosclerosis in HIV-infected adults before and after beginning highly active antiretroviral therapy (HAART). METHODS In the Women's Interagency HIV Study, 127 HIV-infected women studied pre and post HAART were matched to HIV-uninfected controls. Six semiannual measurements of soluble CD14, tumor necrosis factor (TNF) alfa, soluble interleukin (IL) 2 receptor, IL-6, IL-10, monocyte chemoattractant protein 1, D-dimer, and fibrinogen were obtained. Carotid artery intima-media thickness was measured by B-mode ultrasound. RESULTS Relative to HIV-uninfected controls, HAART-naive HIV-infected women had elevated levels of soluble CD14 (1945 vs 1662 ng/mL, Wilcoxon signed rank P < 0.0001), TNF-α (6.3 vs 3.4 pg/mL, P < 0.0001), soluble IL-2 receptor (1587 vs 949 pg/mL, P < 0.0001), IL-10 (3.3 vs 1.9 pg/mL, P < 0.0001), monocyte chemoattractant protein 1 (190 vs 163 pg/mL, P < 0.0001), and D-dimer (0.43 vs 0.31 μg/mL, P < 0.01). Elevated biomarker levels declined after HAART. Although most biomarkers normalized to HIV-uninfected levels, in women on effective HAART, TNF-α levels remained elevated compared with HIV-uninfected women (+0.8 pg/mL, P = 0.0002). Higher post-HAART levels of soluble IL-2 receptor (P = 0.02), IL-6 (P = 0.05), and D-dimer (P = 0.03) were associated with increased carotid artery intima-media thickness. CONCLUSIONS Untreated HIV infection is associated with abnormal hemostasis (eg, D-dimer), proatherogenic (eg, TNF-α), and antiatherogenic (eg, IL-10) inflammatory markers. HAART reduces most inflammatory mediators to HIV-uninfected levels. Increased inflammation and hemostasis are associated with subclinical atherosclerosis in recently treated women. These findings have potential implications for long-term risk of cardiovascular disease in HIV-infected patients, even with effective therapy. |
| Databáze: | OpenAIRE |
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