Department of Infectious Diseases 8632.
Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen.
AIDS. 2024 Mar 15;38(4):487-495. doi: 10.1097/QAD.0000000000003788. Epub 2023 Nov 15.
Clonal hematopoiesis of indeterminate potential (CHIP) has been associated with older age, inflammation and with risk of coronary artery disease (CAD). We aimed to characterize the burden of CHIP, and to explore the association between CHIP, inflammatory markers, and CAD in older persons with HIV (PWH).
From the Copenhagen Comorbidity in HIV Infection (COCOMO) study, we included 190 individuals older than 55 years of age. We defined CHIP as variant allele fraction at least 2%. CAD was categorized according to the most severe coronary artery lesion on coronary computed tomography (CT) angiography as no coronary atherosclerosis; any atherosclerosis defined as at least 1% stenosis and obstructive CAD defined as at least 50% stenosis.
In the entire population (median age 66 years, 87% men), we identified a total of 62 mutations distributed among 49 (26%) participants. The three most mutated genes were DNMT3A , TET2 , and ASXL1 , accounting for 49, 25, and 16% of mutations, respectively. Age and sex were the only variables associated with CHIP. IL-1β, IL-1Ra, IL-2, IL-6, IL-10, soluble CD14, soluble CD163 and TNF-α were not associated with CHIP, and CHIP was not associated with any atherosclerosis or with obstructive CAD in adjusted analyses.
In older, well treated, Scandinavian PWH, more than one in four had at least one CHIP mutation. We did not find evidence of an association between CHIP and inflammatory markers or between CHIP and CAD. CHIP is an unlikely underlying mechanism to explain the association between inflammation and CAD in treated HIV disease.
不确定潜能的克隆性造血(CHIP)与年龄较大、炎症以及冠心病(CAD)风险相关。我们旨在描述 CHIP 的负担,并探讨 CHIP 与炎症标志物以及在老年 HIV 感染者(PWH)中的 CAD 之间的关系。
我们从哥本哈根 HIV 合并症研究(COCOMO)中纳入了 190 名年龄大于 55 岁的个体。我们将 CHIP 定义为变异等位基因分数至少为 2%。CAD 根据冠状动脉计算机断层扫描(CT)血管造影中最严重的冠状动脉病变进行分类,无冠状动脉粥样硬化;任何动脉粥样硬化定义为至少 1%狭窄,阻塞性 CAD 定义为至少 50%狭窄。
在整个人群(中位年龄 66 岁,87%为男性)中,我们共发现了 62 种突变,分布在 49 名(26%)参与者中。突变最多的三个基因是 DNMT3A、TET2 和 ASXL1,分别占突变的 49%、25%和 16%。年龄和性别是唯一与 CHIP 相关的变量。IL-1β、IL-1Ra、IL-2、IL-6、IL-10、可溶性 CD14、可溶性 CD163 和 TNF-α与 CHIP 无关,在调整分析中,CHIP 与任何动脉粥样硬化或阻塞性 CAD 无关。
在年龄较大、治疗良好的斯堪的纳维亚 PWH 中,超过四分之一的人至少有一种 CHIP 突变。我们没有发现 CHIP 与炎症标志物之间或 CHIP 与 CAD 之间存在关联的证据。CHIP 不太可能是解释炎症与治疗后 HIV 疾病中 CAD 之间关系的潜在机制。