Lipids, biomarkers, and subclinical atherosclerosis in treatment-naive HIV patients starting or not starting antiretroviral therapy: Comparison with a healthy control group in a 2-year prospective study
Por:
Di Yacovo, S, Saumoy, M, Sanchez-Quesada, JL, Navarro, A, Sviridov, D, Javaloyas, M, Vila, R, Vernet, A, Low, H, Penafiel, J, Garcia, B, Ordonez-Llanos, J, Podzamczer, D
Publicada:
20 ago 2020
Resumen:
Objective To assess the effect of HIV infection and combined antiretroviral therapy (c-ART) on various proatherogenic biomarkers and lipids and to investigate their relationship with subclinical atherosclerosis in a cohort of treatment-naive HIV-infected patients. Methods We performed a prospective, comparative, multicenter study of 2 groups of treatment-naive HIV-infected patients (group A, CD4>500 cells/mu L, not starting c-ART; and group B, CD4<500 cells/mu L, starting c-ART at baseline) and a healthy control group. Laboratory analyses and carotid ultrasound were performed at baseline and at months 12 and 24. The parameters measured were low-density lipoprotein (LDL) particle phenotype, lipoprotein-associated phospholipase A2 (Lp-PLA2), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), sCD14, sCD163, monocyte chemoattractant protein-1(MCP-1), and asymmetric dimethylarginine (ADMA). A linear mixed model based on patient clusters was used to assess differences in biomarkers between the study groups and over time. Results The study population comprised 62 HIV-infected patients (group A, n = 31; group B, n = 31) and 22 controls. Age was 37 (30-43) years, and 81% were men. At baseline, the HIV-infected patients had a worse LDL particle phenotype and higher plasma concentration of sCD14, sCD163, hs-CRP, and LDL-Lp-PLA2 than the controls. At month 12, there was an increase in total cholesterol (p = 0.002), HDL-c (p = 0.003), and Apo A-I (p = 0.049) and a decrease in sCD14 (p = <0.001) and sCD163 (p<0.001), although only in group B. LDL particle size increased in group B at month 24 (p = 0.038). No changes were observed in group A or in the healthy controls. Common carotid intima-media thickness increased in HIV-infected patients at month 24 (Group A p = 0.053; group B p = 0.048). Plasma levels of sCD14, sCD163, and hs-CRP correlated with lipid values. Conclusions In treatment-naive HIV-infected patients, initiation of c-ART was associated with an improvement in LDL particle phenotype and inflammatory/immune biomarkers, reaching values similar to those of the controls. HIV infection was associated with progression of carotid intima-media thickness.
Filiaciones:
Di Yacovo, S:
Hosp Univ Bellvitge, Bellvitge Biomed Res Inst, HIV & STD Unit, Infect Dis Serv, Lhospitalet De Llobregat, Spain
Saumoy, M:
Hosp Univ Bellvitge, Bellvitge Biomed Res Inst, HIV & STD Unit, Infect Dis Serv, Lhospitalet De Llobregat, Spain
Sanchez-Quesada, JL:
Biomed Res Inst IIB St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Biochem & Mol Biol Dept, Barcelona, Spain
Navarro, A:
Hosp Univ Bellvitge, Bellvitge Biomed Res Inst, HIV & STD Unit, Infect Dis Serv, Lhospitalet De Llobregat, Spain
Sviridov, D:
Baker Heart & Diabet Inst, Melbourne, Vic, Australia
Javaloyas, M:
Hosp Viladecans, Internal Med Serv, Viladecans, Spain
Vila, R:
Hosp Univ Bellvitge, Vasc Surg Serv, Lhospitalet De Llobregat, Spain
Vernet, A:
Univ Rovira & Virgili, Dept Mech Engn, Tarragona, Spain
Low, H:
Baker Heart & Diabet Inst, Melbourne, Vic, Australia
Penafiel, J:
Hosp Univ Bellvitge, Biostat Unit, Lhospitalet De Llobregat, Spain
Univ Barcelona, Barcelona, Spain
Garcia, B:
Hosp Univ Bellvitge, Bellvitge Biomed Res Inst, HIV & STD Unit, Infect Dis Serv, Lhospitalet De Llobregat, Spain
Ordonez-Llanos, J:
Biomed Res Inst IIB St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Biochem & Mol Biol Dept, Barcelona, Spain
Podzamczer, D:
Hosp Univ Bellvitge, Bellvitge Biomed Res Inst, HIV & STD Unit, Infect Dis Serv, Lhospitalet De Llobregat, Spain
Gold, Green Published
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