Factors Associated With Systemic Immune Activation Indices in a Global Primary Cardiovascular Disease Prevention Cohort of People With Human Immunodeficiency Virus on Antiretroviral Therapy . (2nd March 2022)

• Record Type: Journal Article
• Authors: Looby, Sara E; Kantor, Amy; Burdo, Tricia H; Currier, Judith S; Fichtenbaum, Carl J; Overton, Edgar T; Aberg, Judith A; Malvestutto, Carlos D; Bloomfield, Gerald S; Erlandson, Kristine M; Cespedes, Michelle; Kallas, Esper G; Masiá, Mar; Thornton, Alice C; Smith, Mandy D; Flynn, Jacqueline M; Kileel, Emma M; Fulda, Evelynne; Fitch, Kathleen V; Lu, Michael T; Douglas, Pamela S; Grinspoon, Steven K; Ribaudo, Heather J; Zanni, Markella V
• Is Part Of: Clinical infectious diseases. Volume 75:Number 8(2022)
• Page Start: 1324
• Page End: 1333
• Publication Date: 2022-03-02
• Subjects: HIV -- cardiovascular disease risk -- immune activation markers -- women -- reproductive aging; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciac166
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Among antiretroviral therapy (ART)–treated people with human immunodeficiency virus (PWH), persistent systemic immune activation contributes to atherogenesis atherosclerotic, cardiovascular disease (CVD) events, and mortality. Factors associated with key immune activation indices have not previously been characterized among a global primary CVD prevention cohort of PWH. Methods: Leveraging baseline Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) data, we evaluated factors associated with soluble CD14 (sCD14) and oxidized low-density lipoprotein (oxLDL). Results: The primary analysis cohort included 4907 participants from 5 global-burden-of-disease regions (38% female, 48% Black, median age 50 years). In fully adjusted models for sCD14, female sex and White race (among those in high-income regions) were associated with higher sCD14 levels, while higher body mass index (BMI) and current use of nucleoside reverse transcriptase inhibitor + integrase strand transfer inhibitor ART were associated with lower sCD14 levels. In fully adjusted models for oxLDL, male sex, residence in high-income regions, White race (among those in high-income regions), and higher BMI were associated with higher oxLDL levels. In a subanalysis cohort of 1396 women with HIV, increased reproductive age was associated with higher sCD14 levels but not with higher oxLDL levels. Conclusions: Factors associated with sCD14 and oxLDL, 2 key indices of immune-mediated CVD risk, differ. Future studies will elucidate ways in which medications (eg, statins) and behavioral modifications influence sCD14 and oxLDL and the extent to which dampening of these markers mediates CVD-protective effects. Clinical Trials Registration: NCT0234429 . Abstract : Among antiretroviral therapy–treated people with human immunodeficiency virus globally, factors associated with sCD14 and oxLDL, two key indices of immune-mediated cardiovascular disease (CVD) risk, differ. Future studies will elucidate ways in which medications/lifestyle influence these markers and the extent to which dampening these markers mediates CVD risk reduction.