Inflammatory Biomarkers and Carotid Thickness in HIV Infected Patients under Antiretroviral Therapy, Undetectable HIV-1 Viral Load, and Low Cardiovascular Risk
Kaliene Maria Estevão Leite
Gerson Gomes Santos Júnior
Emmanuelle T. A. M Godoi
Adriana Ferraz Vasconcelos
Virgínia Maria Barros Lorena
Paulo Sérgio Ramos Araújo
Kledoaldo Oliveira Lima
Heloisa Ramos Lacerda
Background: People living with HIV are at increased risk of cardiovascular disease and carotid thickness, due to the inflammation caused by the virus, the antiretroviral therapy, and other risk factors. However, few studies have observed the occurrence of cardiovascular diseases and carotid thickness in HIV-positive population at low cardiovascular risk and with undetectable viral load.
Objectives: To evaluate the association between levels of inflammatory markers and carotid thickness in people living with HIV, under antiretroviral therapy and at low cardiovascular risk. Methods: To determine low cardiovascular risk in both groups (HIV infected and non-infected individuals), the Framingham Risk Score was used. Inflammatory markers (IFN-γ, TNF-α, IL-1β, IL-6, sVCAM-1, and sICAM-1) were assessed using flow cytometry. Carotid thickness (mm) was measured using Doppler ultrasound. Level of significance was p < 0.05.
Results: In People living with HIV, age and smoking status were associated with carotid thickness alterations. In the non-HIV group, age, higher total cholesterol, and LDL levels were associated with increased carotid thickness. Using the multivariate analysis, a significant association between TNF-α and IL- 1β levels, and a higher chance of atherosclerosis development in HIV group were observed.
Conclusions: Both groups have a similar risk for developing cardiovascular disease, therefore our study demonstrates that HIV-positive individuals with undetectable viral load in antiretroviral therapy without protease inhibitors and with low cardiovascular risk do not present differences in carotid thickness in relation to uninfected individuals. (Arq Bras Cardiol. 2020; 114(1):90-97)
Keywords: HIV; HIV Infections; Cardiovascular Diseases; Antiretroviral Therapy; Risk Factors; Caroti Artery Diseases; Atherosclerosis.