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Session 149
Poster Abstracts Cardiovascular Risk and Disease Friday, 1:30 - 3:30 pm Hall B |
Background: High-sensitivity C-reactive protein (Hs-CRP)
is a predictor of myocardial infarction and stroke among HIV-uninfected
individuals. Recent studies indicate that HIV patients are at increased risk
for these events; however, the value of Hs-CRP in cardiovascular risk
assessment in HIV disease has not been studied.
Methods: We
evaluated HIV-infected adults consecutively sampled from the clinic-based SCOPE
cohort, as well as HIV-uninfected adults, sampled from the community. Hs-CRP
was measured using the Dade-Behring assay. Carotid artery intima-media
thickness (IMT), a known marker for atherosclerosis, was measured using high
resolution ultrasound. We also assessed lipid levels, coronary risk factors,
HIV disease characteristics, and fat distribution. Multivariable linear
regression was used to identify independent predictors of Hs-CRP.
Results: A
total of 169 HIV-infected and 63 HIV-uninfected subjects were studied. Among
the HIV-infected, 145(87%) were men, and the mean age was 45 ± 8 years. The mean
duration of HIV infection was 12 years. 90 (53%) were current smokers, 51(30%)
had hyperlipidemia, and 38 (22%) had hypertension. The median duration of
protease inhibitor therapy was 3.4 years. The median Hs-CRP level was 1.6 mg/dL
in HIV patients compared with 0.7 mg/L in controls (p = 0.001), and the distribution of CRP values is shown in the
table below: 16 (10%) of the HIV
patients had Hs-CRP levels greater than 10.0 mg/L while none of the uninfected
patients did (p = 0.01). Mean
baseline IMT was 0.93 ± 0.34 mm in HIV patients and 0.74 ± 0.17 mm in
uninfected patients (p < 0.0001).
Carotid IMT and other cardiovascular risk factors did not correlate with Hs-CRP
in HIV patients.
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CRP
Levels in HIV-infected Patients and HIV-uninfected Patients |
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Hs-CRP |
< 1 mg/L |
1.0 to 3.0 mg/L |
3.0 to 10.0 mg/L |
>10.0 mg/L |
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HIV n = 169 |
59 (35%) |
60 (35%) |
34 (20%) |
16 (10%) |
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Controls n = 63 |
34 (54%) |
16 (25%) |
13 (21%) |
0 (0%) |
Conclusions: HIV patients have higher Hs-CRP levels than HIV-uninfected
patients and are more likely to have Hs-CRP values > 10.0 mg/L. In addition,
HIV patients had thicker carotid IMT, a proven marker of atherosclerosis.
However, carotid IMT and Hs-CRP did not correlate in HIV patients. Further
studies are needed to determine whether higher levels of Hs-CRP in HIV patients
reflect chronic infection and/or increased cardiovascular risk.
Keywords: CRP; Atherosclerosis; Inflammation
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