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

PLoS One. 2019 Apr 18;14(4):e0215620. doi: 10.1371/journal.pone.0215620. eCollection 2019.

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.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

  • Anti-Retroviral Agents
  • Lipids
  • MicroRNAs

Grant support

The study was supported by the grant from the National Institutes of Health (HL101274) (www.nih.gov) to MB and DS and in part by the Victorian Government’s OIS Program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.