Background: HIV leads to accelerated atherosclerosis and HCV co-infection further increases the risk of cardiovascular disease (CVD) events. Although HCV improves lipoprotein levels, the effect of increased systemic/vascular inflammation and higher prevalence of insulin resistance may heighten CVD risk in this population. This is presently unknown.
Methods: This is a prospective, matched cross-sectional study to compare arterial stiffness measured by aortic pulse wave velocity (PWV), soluble markers of inflammation and monocyte activation, fasting glucose and lipoprotein levels between adults with HIV/HCV co-infection, HIV only and healthy controls. Adults with HIV-1 RNA <400 copies/ml on stable antiretroviral therapy (ART) (HIV groups) without CVD or diabetes (all groups) were included. Matching criteria were age, sex and CD4+ count (HIV only). ANOVA was used to compare mean PWV, biomarkers, glucose and lipoprotein levels.
Results: 25 HIV/HCV, 23 HIV and 23 controls were included. Demographics were similar except there were more African Americans (48% in HIV/HCV, 57% in HIV, 17% in controls; p<0.01) and smokers (64% in HIV/HCV, 45% in HIV, 22% in controls; p=0.02) in the HIV groups; history of alcohol abuse was more common (40% vs 13% in HIV and 4% in controls; p<0.01); and hypertension (HTN) was less common (4% vs 36% in HIV and 26% in controls; p=0.02) in HIV/HCV. Overall, 70% were men. Median age was 53 years and BMI 26 kg/m2. In the HIV groups, median HIV duration was 13 years; current and nadir CD4+ counts were 441 and 192 cells/mm3; 21% were on protease inhibitors and 92% had HIV-1 RNA <48 cps/ml. PWVs were similar between groups [8.18 m/s for HIV/HCV, 7.81 m/s for HIV; p=0.4 for HIV/HCV vs HIV, and 7.95 m/s for controls; p=0.53 for HIV/HCV vs controls]. Results were similar adjusting for age, race, BMI, smoking, alcohol use and HTN. The figure shows the biomarker analyses. LDL was lower in HIV/HCV compared to the other groups, but oxidized LDL was similar. There was no difference in glucose between groups.
Conclusion: While arterial stiffness was similar between groups, markers of inflammation and monocyte activation were significantly higher among HIV/HCV participants suggesting a possible mechanism for the increased risk of CVD reported in this patient group.
B. Ferrari, None
A. Graham, None
S. Gandhi, None
G. A. Mccomsey, BMS: Consultant , Grant Investigator and Speaker's Bureau , Consulting fee , Research grant and Speaker honorarium
GSK: Consultant and Grant Investigator , Consulting fee and Research grant
Gilead: Consultant and Grant Investigator , Consulting fee and Research grant
Merck: Speaker's Bureau , Speaker honorarium
C. O. Hileman, None
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