Reingold Jason, Wanke Christine, Kotler Donald, Lewis Cora, Tracy Russell, Heymsfield Steven, Tien Phyllis, Bacchetti Peter, Scherzer Rebecca, Grunfeld Carl, Shlipak Michael
University of California, San Francisco, San Francisco, CA, USA.
J Acquir Immune Defic Syndr. 2008 Jun 1;48(2):142-8. doi: 10.1097/QAI.0b013e3181685727.
Inflammation is a potential mechanism to explain the accelerated atherosclerosis observed in HIV- and hepatitis C virus (HCV)-infected persons. We evaluated C-reactive protein (CRP) in HIV-infected and HIV/HCV-coinfected individuals in the era of effective antiretroviral (ARV) therapy.
Cross-sectional study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM) cohort and controls from the Coronary Artery Risk Development in Young Adults (CARDIA) study.
CRP levels were measured in 1135 HIV-infected participants from the FRAM cohort and 281 controls from the CARDIA study. The associations of HIV and HIV/HCV infection with CRP levels were estimated by multivariable linear regression.
Compared with controls, HIV monoinfection was associated with an 88% higher CRP level in men (P < 0.0001) but with no difference in women (5%; P = 0.80) in multivariate analysis. CRP levels were not associated with ARV therapy, HIV RNA level, or CD4 cell count. Compared with controls, HIV/HCV coinfection was associated with a 41% lower CRP level in women (P = 0.012) but with no difference in men (+4%; P = 0.90). Among HIV-infected participants, HCV coinfection was associated with 50% lower CRP levels after multivariable analysis (P < 0.0001) in men and women. Greater visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were strongly associated with CRP levels. Among HIV-infected participants, CRP levels were 17% (P < 0.001) and 21% (P = 0.002) higher per doubling of VAT and SAT; among controls, CRP levels were 34% (P < 0.001) and 61% (P = 0.009) higher, respectively.
In the absence of HCV coinfection, HIV infection is associated with higher CRP levels in men. HCV coinfection is associated with lower CRP levels in men and women.
炎症是一种潜在机制，可用于解释在感染人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）的人群中观察到的动脉粥样硬化加速现象。我们评估了在有效抗逆转录病毒（ARV）治疗时代，HIV感染者和HIV/HCV合并感染者的C反应蛋白（CRP）水平。
对HIV感染脂肪重新分布和代谢变化（FRAM）队列以及来自青年成人冠状动脉风险发展（CARDIA）研究的对照组进行横断面研究。
测量了FRAM队列中的1135名HIV感染者和CARDIA研究中的281名对照组的CRP水平。通过多变量线性回归估计HIV和HIV/HCV感染与CRP水平之间的关联。
与对照组相比，在多变量分析中，HIV单一感染在男性中与CRP水平高88%相关（P<0.0001），但在女性中无差异（5%；P=0.80）。CRP水平与ARV治疗、HIV RNA水平或CD4细胞计数无关。与对照组相比，HIV/HCV合并感染在女性中与CRP水平低41%相关（P=0.012），但在男性中无差异（+4%；P=0.90）。在HIV感染者中，多变量分析后，HCV合并感染在男性和女性中与CRP水平低50%相关（P<0.0001）。更多的内脏脂肪组织（VAT）和皮下脂肪组织（SAT）与CRP水平密切相关。在HIV感染者中，VAT和SAT每增加一倍，CRP水平分别升高17%（P<0.001）和21%（P=0.002）；在对照组中，CRP水平分别升高34%（P<0.001）和61%（P=0.009）。
在无HCV合并感染的情况下，HIV感染与男性较高的CRP水平相关。HCV合并感染与男性和女性较低的CRP水平相关。
