Inflammatory biomarkers and subclinical carotid atherosclerosis in HIV-infected and HIV-uninfected men in the Multicenter AIDS Cohort Study

• Published in: PloS one Vol. 14; no. 4; p. e0214735
• Main Authors: Subramanya, Vinita, McKay, Heather S, Brusca, Rebeccah M, Palella, Frank J, Kingsley, Lawrence A, Witt, Mallory D, Hodis, Howard N, Tracy, Russell P, Post, Wendy S, Haberlen, Sabina A
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 04-04-2019; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Adult; Aged; AIDS; AIDS (Disease); Antiretroviral agents; Arteriosclerosis; Atherosclerosis; Bifurcations; Biological markers; Biomarkers; Biomarkers - blood; Cardiovascular diseases; Care and treatment; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Carotid Artery Diseases - metabolism; Cell activation; Coagulation; Cohort analysis; Cohort Studies; Complications and side effects; Demographics; Demography; Dimers; Endothelium; Fibrin; Fibrinogen; Health aspects; Health risk assessment; Health risks; HIV; HIV infections; HIV Infections - complications; HIV patients; Human immunodeficiency virus; Humans; Inflammation; Intercellular adhesion molecule 1; Interleukin 6; Male; Middle Aged; Monocyte chemoattractant protein 1; Monocytes; Regression Analysis; Regression models; Review boards; Risk analysis; Risk factors; Risk taking; Studies; Ultrasound; Los Angeles California; United States > US; California; Pittsburgh Pennsylvania; Chicago Illinois; Maryland; Baltimore Maryland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0214735

HIV-infected persons have an increased risk of atherosclerosis relative to uninfected individuals. Inflammatory processes may contribute to this risk. We evaluated the associations of 10 biomarkers of systemic inflammation (CRP, IL-6, sTNF-αR1 and 2), monocyte activation (CCL2, sCD163, sCD14), coagulation (fibrinogen, D-dimer), and endothelial dysfunction (ICAM-1) with subclinical carotid atherosclerosis among participants in the Multicenter AIDS Cohort Study (MACS).
Carotid plaque and intima media thickness (IMT) in the common carotid (CCA-IMT) and bifurcation region were assessed by B mode ultrasound among 452 HIV-infected and 276 HIV-uninfected men from 2010-2013. Associations between levels of each biomarker and presence of focal plaque and IMT were assessed by logistic and linear regression models, adjusting for demographics, risk behaviors, traditional cardiovascular disease (CVD) risk factors, and HIV disease characteristics.
Compared to HIV-uninfected men, HIV-infected men had significantly higher levels of 8 of the 10 biomarkers. Overall, men with sCD163, CCL2, IL-6, and CRP levels in the highest quintile had approximately 2 times the odds of carotid plaque relative to those with levels in the lowest quintile, independent of demographic and CVD risk factors. Fibrinogen levels were positively associated with CCA-IMT while ICAM-1, CCL2, and sTNF-αR1 levels were positively associated with bifurcation-IMT. Among HIV-uninfected men, higher levels of sTNF-αR2 were positively associated with CCA-IMT, fibrinogen with bifurcation-IMT and carotid plaque, and ICAM-1 with carotid plaque.
In addition to greater levels of systemic inflammation, heightened monocyte activation (sCD163, CCL2) may contribute to the burden of atherosclerosis among HIV-infected persons.