CT Shows Link Between Inflammatory Biomarkers, Heart Disease in HIV

Noncontrast CT scans show a link between higher inflammatory biomarkers and increased prevalence of coronary artery disease (CAD) in men infected with HIV, according to a study published in the Journal of the American Heart Association.

Researchers from California, Maryland, Vermont, and Pennsylvania investigated associations of inflammatory markers with subclinical coronary artery disease in men with HIV. A total of 923 participants of the Multicenter AIDS Cohort Study were part of the study; 575 were HIV-positive and 348 were HIV-negative. All underwent noncontrast CT scans for coronary artery calcification; 692 also underwent coronary CT angiography. The researchers were looking for presence and extent of coronary artery calcification, plus CT angiography analysis of presence, composition, and extent of coronary plaques and severity of coronary stenosis

The results showed that men who were HIV-positive had significantly higher levels of interleukin‐6 (IL‐6), intercellular adhesion molecule‐1, C‐reactive protein, and soluble‐tumor necrosis factor‐α receptor (sTNFαR) I and II, and a higher prevalence of noncalcified plaque (63% versus 54%) on CT angiography. As well, among the men who were HIV-positive, for every SD increase in log‐interleukin‐6 and log intercellular adhesion molecule‐1, there was a 30% and 60% increase, respectively, in the prevalence of coronary stenosis 50 or higher. Similarly, sTNFαR I and II in HIV-positive participants were associated with an increase in prevalence of coronary stenosis 70% or higher). Higher levels of interleukin‐6, sTNFαR I, and sTNFαR II were also associated with greater coronary artery calcification score in HIV-positive men.[[{"type":"media","view_mode":"media_crop","fid":"51229","attributes":{"alt":"Hossein Bahrami, MD, PhD","class":"media-image media-image-right","id":"media_crop_5280059448608","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"6311","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"float: right;","title":"Hossein Bahrami, MD, PhD","typeof":"foaf:Image"}}]]

“Although this study does not definitely prove the causal relationship between these markers and heart disease, it is suggestive of a possible role that persistent inflammation (even in HIV infected patients that are under appropriate treatments) may play in increasing the risk of heart disease in these patients,” lead author Hossein Bahrami, MD, PhD, assistant professor of cardiovascular medicine at the Keck School of Medicine of the University of Southern California (USC), said in a release.

"Inflammation has only recently been studied as a possible reason for chronic heart disease," Bahrami said. "Confirming the relationship between HIV-related inflammation and the marked increase of CAD among men infected with HIV allows us to move forward in our attempts to better manage the health of these patients according to their specific medical needs."