Introduction
HIV+ adults have heightened monocyte activation and inflammation, at least partially due to altered gut integrity. The role of dietary factors on microbial translocation, inflammation and the downstream effect on markers of cardiovascular disease (CVD) has not been explored. Our purpose was to describe the longitudinal dietary patterns of HIV+ adults; and examine the relationship between dietary intake, gut integrity, inflammation and subclinical markers of CVD in HIV+ adults.
Methods
We conducted a secondary analysis of 147 HIV+ participants in a 96-week randomized clinical trial of rosuvastatin as primary CVD prevention. Dietary intake was assessed using a dietary recall; plasma gut integrity, monocyte activation and inflammation markers measured by ELISA; CVD risk assessed by carotid ultrasound and coronary artery calcium score. Linear mixed models were used to analyze longitudinally measured biomarkers.
Results
Median age was 45 years and 78% were male. At baseline participants consumed a mean (SD) of 108 (70) grams of fat daily, 19 (15.6) grams of fiber, 266 (186) grams of carbohydrates, 15.6 (5.9) grams of protein; 45% of the sample consumed alcohol. Over time, alcohol consumption was associated with several markers of gut integrity and inflammation (all p’s<0.05).
Discussion
HIV+ adults in a contemporary, high-resource setting have poor dietary patterns. Alcohol use was associated with worse gut integrity and increased inflammation, while other aspects of diet (fiber, carbohydrates, fat) were not. These data add to growing evidence illustrating the need for a better understanding of the effect of lifestyle factors on comorbidities in HIV+ adults.