Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Clin Infect Dis. 2022 Oct 12;75(8):1324-1333. doi: 10.1093/cid/ciac166.
Among antiretroviral therapy (ART)-treated people with human immunodeficiency virus (PWH), persistent systemic immune activation contributes to atherogenesis atherosclerotic, cardiovascular disease (CVD) events, and mortality. Factors associated with key immune activation indices have not previously been characterized among a global primary CVD prevention cohort of PWH.
Leveraging baseline Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) data, we evaluated factors associated with soluble CD14 (sCD14) and oxidized low-density lipoprotein (oxLDL).
The primary analysis cohort included 4907 participants from 5 global-burden-of-disease regions (38% female, 48% Black, median age 50 years). In fully adjusted models for sCD14, female sex and White race (among those in high-income regions) were associated with higher sCD14 levels, while higher body mass index (BMI) and current use of nucleoside reverse transcriptase inhibitor + integrase strand transfer inhibitor ART were associated with lower sCD14 levels. In fully adjusted models for oxLDL, male sex, residence in high-income regions, White race (among those in high-income regions), and higher BMI were associated with higher oxLDL levels. In a subanalysis cohort of 1396 women with HIV, increased reproductive age was associated with higher sCD14 levels but not with higher oxLDL levels.
Factors associated with sCD14 and oxLDL, 2 key indices of immune-mediated CVD risk, differ. Future studies will elucidate ways in which medications (eg, statins) and behavioral modifications influence sCD14 and oxLDL and the extent to which dampening of these markers mediates CVD-protective effects.
NCT0234429.
在接受抗逆转录病毒疗法（ART）治疗的人类免疫缺陷病毒（HIV）感染者（PWH）中，持续的全身免疫激活导致动脉粥样硬化、心血管疾病（CVD）事件和死亡率。以前尚未在 PWH 的全球主要 CVD 预防队列中描述与关键免疫激活指标相关的因素。
利用随机预防 HIV 血管事件试验（REPRIEVE）的基线数据，我们评估了与可溶性 CD14（sCD14）和氧化型低密度脂蛋白（oxLDL）相关的因素。
主要分析队列包括来自全球疾病负担 5 个地区的 4907 名参与者（38%为女性，48%为黑人，中位年龄为 50 岁）。在 sCD14 的完全调整模型中，女性性别和白种人种族（在高收入地区）与较高的 sCD14 水平相关，而较高的体重指数（BMI）和当前使用核苷逆转录酶抑制剂+整合酶链转移抑制剂 ART 与较低的 sCD14 水平相关。在 oxLDL 的完全调整模型中，男性性别、居住在高收入地区、白种人种族（在高收入地区）和较高的 BMI 与较高的 oxLDL 水平相关。在 1396 名 HIV 女性的亚分析队列中，生育年龄的增加与较高的 sCD14 水平相关，但与较高的 oxLDL 水平无关。
与 sCD14 和 oxLDL 相关的因素，这 2 个免疫介导的 CVD 风险的关键指标不同。未来的研究将阐明药物（例如他汀类药物）和行为改变如何影响 sCD14 和 oxLDL，以及这些标志物的抑制在多大程度上介导 CVD 保护作用。
NCT0234429。
