Objective
The pathogenesis of immune dysfunction in chronic HIV-1 infection is unclear, and a potential role for oxidized lipids has been suggested. We hypothesize that both oxidized low- and high-density lipoproteins (HDLox, LDLox) contribute to HIV-1 related immune dysfunction.
Study
In the AIDS Clinical Trials Group (ACTG) A5260, 234 HIV-infected antiretroviral therapy (ART)-naïve participants were randomized to receive tenofovir-emtricitabine plus protease inhibitors or raltegravir and had HIV-1 RNA <50 copies/ml by week 24 and thereafter.
Methods
Associations between biomarkers of inflammation (IL-6, hs-CRP, D-Dimer), immune activation (sCD163, sCD14, sIL-2r, CD38, HLA-DR), inflammatory monocytes (CD14+CD16+), T cell senescence (CD28, CD57) and exhaustion (PD1) and HDLox, LDLox were assessed at entry and after ART (week 96) with Spearman (partial) correlations.
Results
HDLox declined and LDLox increased over 96 weeks of ART. Positive associations were observed at baseline and over time between HDLox, (but not consistently for LDLox) and most markers of inflammation and immune activation (but not senescence/exhaustion), even after adjustment for multiple comparisons, demographics, entry CD4 count and HIV-1 RNA. HDLox was positively associated with IL-6 (r=0.19–0.29, p<0.01), and sCD163 (r=0.14–0.41 p≤0.04) at all timepoints.
Conclusions
These prospective longitudinal data suggest that oxidized lipoproteins may contribute to persistent immune activation on ART.