Perivascular fat, inflammation, and cardiovascular risk in HIV-infected patients on antiretroviral therapy

Abstract Background HIV-infection is characterized by chronic immune activation that persists despite effective antiretroviral therapy (ART) and is associated with elevated cardiovascular risk. Whether specific perivascular fat depots are associated with inflammation in HIV is unknown. Methods In a...

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Published inInternational journal of cardiology Vol. 168; no. 4; pp. 4039 - 4045
Main Authors Longenecker, Chris T, Jiang, Ying, Yun, Chun-Ho, Debanne, Sara, Funderburg, Nicholas T, Lederman, Michael M, Storer, Norma, Labbato, Danielle E, Bezerra, Hiram G, McComsey, Grace A
Format Journal Article
LanguageEnglish
Published Shannon Elsevier Ireland Ltd 09.10.2013
Elsevier
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Summary:Abstract Background HIV-infection is characterized by chronic immune activation that persists despite effective antiretroviral therapy (ART) and is associated with elevated cardiovascular risk. Whether specific perivascular fat depots are associated with inflammation in HIV is unknown. Methods In a cross-sectional study, epicardial (EAT) and thoracic periaortic (TAT) adipose tissue volumes were measured by computed tomography in 100 HIV-infected adults, on stable ART, with LDL-cholesterol ≤ 130 mg/dL and evidence of heightened T-cell activation (CD8+CD38+HLA-DR+ ≥ 19%) or increased inflammation (high sensitivity C-reactive protein ≥ 2 mg/L). Results Overall, 77% were males and 70% African American. Mean (standard deviation) age and body mass index were 47 (10) years and 28 (6.4) kg/m2 , respectively. All subjects had HIV-1 RNA < 1000 copies/mL with mean (standard deviation) CD4 + T cell count of 665 (280) cells/μL; 50% were on a protease inhibitor. EAT and TAT were correlated with each other (r = 0.766, p < 0.0001). Both were associated with metabolic syndrome, atherogenic lipid profile, insulin resistance, total and central body fat, serum biomarkers of inflammation, and soluble CD163, but not with cellular immune activation markers. In multivariable models that adjusted for age, sex, and other measures of adiposity, both perivascular fat depots were independently associated with the presence of coronary calcium. Conclusions Perivascular fat is associated with soluble CD163, biomarkers of inflammation, insulin resistance, and subclinical atherosclerosis in this population of virologically suppressed HIV-infected patients on ART. The association of perivascular fat with coronary artery calcification appears to be independent of other measures of adiposity.
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This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2013.06.059