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

• Published in: International 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
• Language: English
• Published: Shannon Elsevier Ireland Ltd 09.10.2013; Elsevier
• Subjects: Adipose tissue; Adipose Tissue - drug effects; Adipose Tissue - pathology; Adult; Anti-Retroviral Agents - adverse effects; Anti-Retroviral Agents - pharmacology; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Cardiovascular Diseases - chemically induced; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cross-Sectional Studies; Double-Blind Method; Female; Heart; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; Human viral diseases; Humans; Infectious diseases; Inflammation; Inflammation - chemically induced; Inflammation - diagnosis; Inflammation - epidemiology; Macrophages; Male; Medical sciences; Middle Aged; Pericardium - drug effects; Pericardium - pathology; Pharmacology. Drug treatments; Risk Factors; Vascular Calcification - chemically induced; Vascular Calcification - diagnosis; Vascular Calcification - epidemiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Inflammation; Adipose tissue; HIV; Macrophages; Atherosclerosis; Antiretroviral agent; Cardiovascular disease; Vascular disease; Antiviral; Cardiology; Immunopathology; Retroviridae; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Chemotherapy; Treatment; Viral disease; Risk factor; Cardiovascular risk; Fat; Human immunodeficiency virus; Macrophage
• DOI: 10.1016/j.ijcard.2013.06.059
• ISSN: 0167-5273

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.