Elevated levels of monocyte activation markers are associated with subclinical atherosclerosis in men with and those without HIV infection

J Infect Dis. 2015 Apr 15;211(8):1219-28. doi: 10.1093/infdis/jiu594. Epub 2014 Oct 30.


Background: Heightened immune activation among human immunodeficiency virus (HIV)-infected persons may contribute to atherosclerosis. We assessed associations of serologic markers of monocyte activation, soluble CD163 (sCD163) and soluble CD14 (sCD14), and monocyte chemoattractant protein 1 (CCL2) with subclinical atherosclerosis among men with and those without HIV infection in the Multicenter AIDS Cohort Study.

Methods: We performed noncontrast computed tomography on 906 men (566 HIV-infected men and 340 HIV-uninfected men), 709 of whom also underwent coronary computed tomographic angiography. Associations between each biomarker and the prevalence of coronary plaque, the prevalence of stenosis of ≥50%, and the extent of plaque were assessed by logistic and linear regression, adjusting for age, race, HIV serostatus, and cardiovascular risk factors.

Results: Levels of all biomarkers were higher among HIV-infected men, of whom 81% had undetectable HIV RNA, and were associated with lower CD4(+) T-cell counts. In the entire population and among HIV-infected men, higher biomarker levels were associated with a greater prevalence of coronary artery stenosis of ≥50%. Higher sCD163 levels were also associated with greater prevalences of coronary artery calcium, mixed plaque, and calcified plaque; higher CCL2 levels were associated with a greater extent of noncalcified plaque.

Conclusions: sCD163, sCD14, and CCL2 levels were elevated in treated HIV-infected men and associated with atherosclerosis. Monocyte activation may increase the risk for cardiovascular disease in individuals with HIV infection.

Keywords: atherosclerosis; human immunodeficiency virus; inflammation; monocyte activation; plaque.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antigens, CD / immunology
  • Antigens, CD / metabolism
  • Antigens, Differentiation, Myelomonocytic / immunology
  • Antigens, Differentiation, Myelomonocytic / metabolism
  • Atherosclerosis / immunology*
  • Biomarkers / metabolism*
  • CD4-Positive T-Lymphocytes / immunology
  • CD4-Positive T-Lymphocytes / metabolism
  • Calcium / metabolism
  • Chemokine CCL2 / immunology
  • Chemokine CCL2 / metabolism
  • Cohort Studies
  • Coronary Angiography / methods
  • Coronary Stenosis / immunology
  • Coronary Stenosis / metabolism
  • HIV Infections / immunology*
  • HIV Infections / metabolism
  • Humans
  • Lipopolysaccharide Receptors / immunology
  • Lipopolysaccharide Receptors / metabolism
  • Male
  • Middle Aged
  • Monocytes / immunology*
  • Monocytes / metabolism
  • Plaque, Atherosclerotic / immunology
  • Plaque, Atherosclerotic / metabolism
  • Prevalence
  • Receptors, Cell Surface / immunology
  • Receptors, Cell Surface / metabolism
  • Risk Factors
  • Tomography, X-Ray Computed / methods


  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • Biomarkers
  • CD163 antigen
  • Chemokine CCL2
  • Lipopolysaccharide Receptors
  • Receptors, Cell Surface
  • Calcium