Subclinical cardiovascular disease in HIV controller and long-term nonprogressor populations

R. M. Brusca, D. B. Hanna, N. I. Wada, J. N. Blankson, M. D. Witt, L. P. Jacobson, L. Kingsley, F. J. Palella, M. Budoff, T. T. Brown, K. Anastos, J. M. Lazar, W. J. Mack, P. Bacchetti, P. C. Tien, Y. Golzar, M. Plankey, E. Golub, R. C. Kaplan, W. S. Post

Research output: Contribution to journalArticle

Abstract

Objectives: Elite controllers (ECs), viraemic controllers (VCs), and long-term nonprogressors (LTNPs) control HIV viral replication or maintain CD4 T-cell counts without antiretroviral therapy, but may have increased cardiovascular disease (CVD) risk compared to HIV-uninfected persons. We evaluated subclinical carotid and coronary atherosclerosis and inflammatory biomarker levels among HIV controllers, LTNPs and noncontrollers and HIV-uninfected individuals in the Multicenter AIDS Cohort Study (MACS) and the Women’s Interagency HIV Study (WIHS). Methods: We measured carotid plaque presence and common carotid artery intima-media thickness (IMT) in 1729 women and 1308 men, and the presence of coronary artery calcium and plaque in a subgroup of men. Associations between HIV control category and carotid and coronary plaque prevalences were assessed by multivariable regression analyses adjusting for demographics and CVD risk factors. Serum inflammatory biomarker concentrations [soluble CD163 (sCD163), soluble CD14 (sCD14), galectin-3 (Gal-3), galectin-3 binding protein (Gal-3BP) and interleukin (IL)-6] were measured and associations with HIV control category assessed. Results: We included 135 HIV controllers (30 ECs) and 135 LTNPs in the study. Carotid plaque prevalence and carotid IMT were similar in HIV controllers, LTNPs and HIV-uninfected individuals. HIV controllers and LTNPs had lower prevalences of carotid plaque compared to viraemic HIV-infected individuals. The prevalence of coronary atherosclerosis was similar in HIV controllers/LTNPs compared to HIV-uninfected and viraemic HIV-infected men. Controllers and LTNPs had higher concentrations of sCD163 and sCD14 compared to HIV-uninfected persons. Conclusions: Subclinical CVD was similar in HIV controllers, LTNPs and HIV-uninfected individuals despite elevated levels of some inflammatory biomarkers. Future studies of HIV controllers and LTNPs are needed to characterize the risk of CVD among HIV-infected persons.

Original languageEnglish (US)
JournalHIV Medicine
DOIs
StateAccepted/In press - Jan 1 2019

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Cardiovascular Diseases
HIV
Population
HIV Long-Term Survivors
Carotid Intima-Media Thickness
Biomarkers
Coronary Artery Disease
Galectins
Galectin 3
Carotid Artery Diseases
Common Carotid Artery
CD4 Lymphocyte Count
Interleukin-6
Coronary Vessels
Acquired Immunodeficiency Syndrome
Cohort Studies
Regression Analysis
Demography
Calcium
T-Lymphocytes

Keywords

  • AIDS
  • carotid atherosclerosis
  • coronary atherosclerosis
  • HIV
  • subclinical cardiovascular disease

ASJC Scopus subject areas

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Brusca, R. M., Hanna, D. B., Wada, N. I., Blankson, J. N., Witt, M. D., Jacobson, L. P., ... Post, W. S. (Accepted/In press). Subclinical cardiovascular disease in HIV controller and long-term nonprogressor populations. HIV Medicine. https://doi.org/10.1111/hiv.12820

Subclinical cardiovascular disease in HIV controller and long-term nonprogressor populations. / Brusca, R. M.; Hanna, D. B.; Wada, N. I.; Blankson, J. N.; Witt, M. D.; Jacobson, L. P.; Kingsley, L.; Palella, F. J.; Budoff, M.; Brown, T. T.; Anastos, K.; Lazar, J. M.; Mack, W. J.; Bacchetti, P.; Tien, P. C.; Golzar, Y.; Plankey, M.; Golub, E.; Kaplan, R. C.; Post, W. S.

In: HIV Medicine, 01.01.2019.

Research output: Contribution to journalArticle

Brusca, RM, Hanna, DB, Wada, NI, Blankson, JN, Witt, MD, Jacobson, LP, Kingsley, L, Palella, FJ, Budoff, M, Brown, TT, Anastos, K, Lazar, JM, Mack, WJ, Bacchetti, P, Tien, PC, Golzar, Y, Plankey, M, Golub, E, Kaplan, RC & Post, WS 2019, 'Subclinical cardiovascular disease in HIV controller and long-term nonprogressor populations', HIV Medicine. https://doi.org/10.1111/hiv.12820
Brusca, R. M. ; Hanna, D. B. ; Wada, N. I. ; Blankson, J. N. ; Witt, M. D. ; Jacobson, L. P. ; Kingsley, L. ; Palella, F. J. ; Budoff, M. ; Brown, T. T. ; Anastos, K. ; Lazar, J. M. ; Mack, W. J. ; Bacchetti, P. ; Tien, P. C. ; Golzar, Y. ; Plankey, M. ; Golub, E. ; Kaplan, R. C. ; Post, W. S. / Subclinical cardiovascular disease in HIV controller and long-term nonprogressor populations. In: HIV Medicine. 2019.
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abstract = "Objectives: Elite controllers (ECs), viraemic controllers (VCs), and long-term nonprogressors (LTNPs) control HIV viral replication or maintain CD4 T-cell counts without antiretroviral therapy, but may have increased cardiovascular disease (CVD) risk compared to HIV-uninfected persons. We evaluated subclinical carotid and coronary atherosclerosis and inflammatory biomarker levels among HIV controllers, LTNPs and noncontrollers and HIV-uninfected individuals in the Multicenter AIDS Cohort Study (MACS) and the Women’s Interagency HIV Study (WIHS). Methods: We measured carotid plaque presence and common carotid artery intima-media thickness (IMT) in 1729 women and 1308 men, and the presence of coronary artery calcium and plaque in a subgroup of men. Associations between HIV control category and carotid and coronary plaque prevalences were assessed by multivariable regression analyses adjusting for demographics and CVD risk factors. Serum inflammatory biomarker concentrations [soluble CD163 (sCD163), soluble CD14 (sCD14), galectin-3 (Gal-3), galectin-3 binding protein (Gal-3BP) and interleukin (IL)-6] were measured and associations with HIV control category assessed. Results: We included 135 HIV controllers (30 ECs) and 135 LTNPs in the study. Carotid plaque prevalence and carotid IMT were similar in HIV controllers, LTNPs and HIV-uninfected individuals. HIV controllers and LTNPs had lower prevalences of carotid plaque compared to viraemic HIV-infected individuals. The prevalence of coronary atherosclerosis was similar in HIV controllers/LTNPs compared to HIV-uninfected and viraemic HIV-infected men. Controllers and LTNPs had higher concentrations of sCD163 and sCD14 compared to HIV-uninfected persons. Conclusions: Subclinical CVD was similar in HIV controllers, LTNPs and HIV-uninfected individuals despite elevated levels of some inflammatory biomarkers. Future studies of HIV controllers and LTNPs are needed to characterize the risk of CVD among HIV-infected persons.",
keywords = "AIDS, carotid atherosclerosis, coronary atherosclerosis, HIV, subclinical cardiovascular disease",
author = "Brusca, {R. M.} and Hanna, {D. B.} and Wada, {N. I.} and Blankson, {J. N.} and Witt, {M. D.} and Jacobson, {L. P.} and L. Kingsley and Palella, {F. J.} and M. Budoff and Brown, {T. T.} and K. Anastos and Lazar, {J. M.} and Mack, {W. J.} and P. Bacchetti and Tien, {P. C.} and Y. Golzar and M. Plankey and E. Golub and Kaplan, {R. C.} and Post, {W. S.}",
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AU - Brusca, R. M.

AU - Hanna, D. B.

AU - Wada, N. I.

AU - Blankson, J. N.

AU - Witt, M. D.

AU - Jacobson, L. P.

AU - Kingsley, L.

AU - Palella, F. J.

AU - Budoff, M.

AU - Brown, T. T.

AU - Anastos, K.

AU - Lazar, J. M.

AU - Mack, W. J.

AU - Bacchetti, P.

AU - Tien, P. C.

AU - Golzar, Y.

AU - Plankey, M.

AU - Golub, E.

AU - Kaplan, R. C.

AU - Post, W. S.

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N2 - Objectives: Elite controllers (ECs), viraemic controllers (VCs), and long-term nonprogressors (LTNPs) control HIV viral replication or maintain CD4 T-cell counts without antiretroviral therapy, but may have increased cardiovascular disease (CVD) risk compared to HIV-uninfected persons. We evaluated subclinical carotid and coronary atherosclerosis and inflammatory biomarker levels among HIV controllers, LTNPs and noncontrollers and HIV-uninfected individuals in the Multicenter AIDS Cohort Study (MACS) and the Women’s Interagency HIV Study (WIHS). Methods: We measured carotid plaque presence and common carotid artery intima-media thickness (IMT) in 1729 women and 1308 men, and the presence of coronary artery calcium and plaque in a subgroup of men. Associations between HIV control category and carotid and coronary plaque prevalences were assessed by multivariable regression analyses adjusting for demographics and CVD risk factors. Serum inflammatory biomarker concentrations [soluble CD163 (sCD163), soluble CD14 (sCD14), galectin-3 (Gal-3), galectin-3 binding protein (Gal-3BP) and interleukin (IL)-6] were measured and associations with HIV control category assessed. Results: We included 135 HIV controllers (30 ECs) and 135 LTNPs in the study. Carotid plaque prevalence and carotid IMT were similar in HIV controllers, LTNPs and HIV-uninfected individuals. HIV controllers and LTNPs had lower prevalences of carotid plaque compared to viraemic HIV-infected individuals. The prevalence of coronary atherosclerosis was similar in HIV controllers/LTNPs compared to HIV-uninfected and viraemic HIV-infected men. Controllers and LTNPs had higher concentrations of sCD163 and sCD14 compared to HIV-uninfected persons. Conclusions: Subclinical CVD was similar in HIV controllers, LTNPs and HIV-uninfected individuals despite elevated levels of some inflammatory biomarkers. Future studies of HIV controllers and LTNPs are needed to characterize the risk of CVD among HIV-infected persons.

AB - Objectives: Elite controllers (ECs), viraemic controllers (VCs), and long-term nonprogressors (LTNPs) control HIV viral replication or maintain CD4 T-cell counts without antiretroviral therapy, but may have increased cardiovascular disease (CVD) risk compared to HIV-uninfected persons. We evaluated subclinical carotid and coronary atherosclerosis and inflammatory biomarker levels among HIV controllers, LTNPs and noncontrollers and HIV-uninfected individuals in the Multicenter AIDS Cohort Study (MACS) and the Women’s Interagency HIV Study (WIHS). Methods: We measured carotid plaque presence and common carotid artery intima-media thickness (IMT) in 1729 women and 1308 men, and the presence of coronary artery calcium and plaque in a subgroup of men. Associations between HIV control category and carotid and coronary plaque prevalences were assessed by multivariable regression analyses adjusting for demographics and CVD risk factors. Serum inflammatory biomarker concentrations [soluble CD163 (sCD163), soluble CD14 (sCD14), galectin-3 (Gal-3), galectin-3 binding protein (Gal-3BP) and interleukin (IL)-6] were measured and associations with HIV control category assessed. Results: We included 135 HIV controllers (30 ECs) and 135 LTNPs in the study. Carotid plaque prevalence and carotid IMT were similar in HIV controllers, LTNPs and HIV-uninfected individuals. HIV controllers and LTNPs had lower prevalences of carotid plaque compared to viraemic HIV-infected individuals. The prevalence of coronary atherosclerosis was similar in HIV controllers/LTNPs compared to HIV-uninfected and viraemic HIV-infected men. Controllers and LTNPs had higher concentrations of sCD163 and sCD14 compared to HIV-uninfected persons. Conclusions: Subclinical CVD was similar in HIV controllers, LTNPs and HIV-uninfected individuals despite elevated levels of some inflammatory biomarkers. Future studies of HIV controllers and LTNPs are needed to characterize the risk of CVD among HIV-infected persons.

KW - AIDS

KW - carotid atherosclerosis

KW - coronary atherosclerosis

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