Association Between Inflammation and Coagulation Biomarkers and Carotid Atherosclerosis Among Treated People With Human Immunodeficiency Virus

Abstract

Background Atherosclerotic cardiovascular disease (CVD) is a common cause of morbidity among people with HIV (PWH) who initiate antiretroviral therapy (ART). Little is known about the roles of inflammation in atherosclerotic CVD among people with HIV (PWH). Methods This cross-sectional evaluation included 178 PWH between 40 and 70 years on stable (>3 months) ART who were derived from the ongoing prospective cohort for Comparative HIV and Aging Research in Taizhou (CHART), China from February 2017 to August 2018. Carotid intima-media thickness (cIMT) ≥ 1 mm was considered as cIMT thickening indicative of atherosclerotic CVD. Plasma inflammation and coagulation biomarkers were quantified by a multiplex bead cytokine assay for 27 cytokines and enzyme linked immunosorbent assay (ELISA) for sCD14 and D-dimer, respectively. We performed a series of multiparametric analyses of biomarkers and developed a composite score for atherosclerotic CVD assessment among PWH. Results Of 178 PWH, 53 (30.9%) had cIMT thickening. In multivariable logistic analysis adjusting for CVD and HIV-specific risk factors, IL-4 (OR=19.0; 95% CI:1.6–226.5), IL-7 (OR=16.7; 95% CI: 1.8–151.7), IL-10 (OR=11.9; 95% CI: 2.0–72.1) and D-dimer (OR=3.1; 95%CI:1.0–10.1) were significantly associated with cIMT thickening. We also developed a composite score incorporating markers (IL-7, IL-10, D-dimer, and hypertension) that accurately evaluated atherosclerotic CVD. Conclusions The associations of IL-4, IL-7, IL-10, and D-dimer with atherosclerosis underscores research needs to further understand the inflammatory mechanisms in the pathogenesis of atherosclerosis CVD among treated PWH. The composite score for atherosclerotic CVD assessment could be useful for risk stratification in PWH.

Six-month immune responses to mRNA-1273 vaccine in combination antiretroviral therapy treated late presenter people with HIV according to previous SARS-CoV-2 infection

“…Furthermore, -in accordance with prior data in HIVnegative vaccinees [59,[77][78][79][80] -HCWs only spread SARS-CoV-2-specific Th1 cells, while LP-PWH developed vaccine-induced Th1 but also Th2-like (IL-4þ) cells. A predominance of Th2 immune responses has long been known as main feature of HIV infection [81][82][83][84]. Furthermore, skewed T-cell responses to vaccinesincluding those against SARS-CoV-2 -with a predominant Th2 polarization have been described to associate with the aging-related immunosenescence [85][86][87][88][89].…”