HIV disease, metabolic dysfunction and atherosclerosis: A three year prospective study.

Abstract

HIV infection is known to be associated with cardiometabolic abnormalities; here we investigated the progression and causes of these abnormalities. Three groups of participants were recruited: HIV-negative subjects and two groups of treatment-naïve HIV-positive subjects, one group initiating antiretroviral treatment, the other remaining untreated. Intima-media thickness (cIMT) increased in HIV-positive untreated group compared to HIV-negative group, but treatment mitigated the difference. We found no increase in diabetes-related metabolic markers or in the level of inflammation in any of the groups. Total cholesterol, low density lipoprotein cholesterol and apoB levels were lower in HIV-positive groups, while triglyceride and Lp(a) levels did not differ between the groups. We found a statistically significant negative association between viral load and plasma levels of total cholesterol, LDL cholesterol, HDL cholesterol, apoA-I and apoB. HIV-positive patients had hypoalphalipoproteinemia at baseline, and we found a redistribution of sub-populations of high density lipoprotein (HDL) particles with increased proportion of smaller HDL in HIV-positive untreated patients, which may result from increased levels of plasma cholesteryl ester transfer protein in this group. HDL functionality declined in the HIV-negative and HIV-positive untreated groups, but not in HIV-positive treated group. We also found differences between HIV-positive and negative groups in plasma abundance of several microRNAs involved in lipid metabolism. Our data support a hypothesis that cardiometabolic abnormalities in HIV infection are caused by HIV and that antiretroviral treatment itself does not influence key cardiometabolic parameters, but mitigates those affected by HIV.

• Authors: Hann Low, Anh Hoang, Tatiana Pushkarsky, Larisa Dubrovsky, Elizabeth Dewar, Maria-Silvana Di Yacovo, Nigora Mukhamedova, Lesley Cheng, Catherine Downs, Gary Simon, Maria Saumoy, Andrew F Hill, Michael L Fitzgerald, Paul Nestel, Anthony Dart, Jennifer Hoy, Michael Bukrinsky, Dmitri Sviridov
• Journal: PloS one (PLoS One) Vol. 14 Issue 4 Pg. e0215620 ( 2019) ISSN: 1932-6203 [Electronic] United States
• PMID: 30998801 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Retroviral Agents
• Lipids
• MicroRNAs

Topics

• Adult
• Anti-Retroviral Agents (administration & dosage)
• Atherosclerosis (blood, prevention & control)
• Female
• HIV Infections (blood, drug therapy)
• HIV-1
• Humans
• Hypoalphalipoproteinemias (blood, prevention & control)
• Lipids (blood)
• Male
• MicroRNAs (blood)
• Middle Aged
• Prospective Studies