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Session 91 Poster Session Cardiovascular Disease Risk Session Time: 4:30-6:30 pm Room 4E-F

694-T. ACTG 5056: C-Reactive Protein (CRP) Levels and Cardiovascular Risk Status for a Cohort of HIV-1-Infected Persons Durably Suppressed on an Indinavir (IDV)-Containing Regimen K. Henry*1, R. Zackin2, M. Dube3, S. Hammer4, D. Sprecher5, and J. Currier6 for the ACTG 5056/372A Team 1Univ. of Minnesota, Minneapolis; 2Harvard Univ., Boston, MA; 3Indiana Univ., Indianapolis; 4Columbia Univ., New York, NY; 5Cleveland Clin., OH; and 6Univ. of California, Los Angeles Background: CRP levels are a marker of chronic inflammation and have been linked to increased risk for coronary artery disease (CAD). This analysis assessed CRP levels and association of CRP with CAD risk and surrogate marker status in a cohort of HIV-1-infected patients who achieved durable suppression on a regimen that included IDV (ACTG 372A). Methods: A random sample of 99 ACTG 372A study subjects had CAD risk information obtained along with fasting blood samples. CRP was measured using an ultrasensitive immunonephelometric assay (Dade-Behring, CV= 5%). Results: The median age of the study subjects was 40.5. 32% reported smoking, 14% hypertension, and 10% diabetes. The median time on indinavir was 42 months. The median CRP level (n=99) was 2.29 mg/L (range=0.18-42.9). The distribution of CRP levels by CAD risk categories was: average risk (< 0.55/<1.39 mg/L) =22 subjects; low risk (0.56-1.14/1.4-2.85 mg/L) = 15 subjects; moderate risk (1.15-2.1/2.86-5.25 mg/L) = 13 subjects; and high risk (> 2.1/>5.25 mg/L) = 49 subjects. The proportion of subjects with high-risk CRP levels was significantly greater than in the general population (p< 0.001). High-risk CRP values were associated with greater age (p=0.03), fibrinogen levels (p< 0.001), triglyceride levels (p=0.005), HOMA score (p=0.047), WBC (p=0.008), lower HDL levels (p=0.003), lp(a) level (p=0.001), and Framingham cardiovascular disease risk scores (p=0.05). High-risk CRP levels were not associated with the baseline, current,or change in CD4+ T-cell levels, or baseline HIV-1 RNA. Conclusions: In this cohort of durably suppressed HIV-1-infected persons, elevated CRP levels were observed, and tended to cluster with other CAD risk factors. The relationship of this marker of chronic inflammation, in patients with virologically suppressed HIV infection, with long-term CAD risk remains to be defined.

©2002 9th Conference on Retroviruses and Opportunistic Infections