1061 
Association of HIV Infection and HIV/HCV Co-infection with C-reactive Protein Levels: The FRAM Study
J Reingold1,2, C Wanke3, D Kotler4, C Lewis5, S Heymsfield6, P Tien1,2, P Bacchetti1, R Scherzer2, Carl Grunfeld*1,2, M Shlipak1,2, and FRAM study
1Univ of California, San Francisco, US; 2VAMC, San Francisco, CA, US; 3Tufts Univ, Boston, MA, US; 4St Luke`s Roosevelt Hosp, New York, NY, US; 5Univ of Alabama at Birmingham, US; and 6Merck Res Labs, Rahway, NJ, US
Background: Chronic infections such as HIV and hepatitis
C virus (HCV) have been associated with an increased risk of cardiovascular
disease, with inflammation being a possible mechanism. However, little is known
about inflammation as assessed by C-reactive protein (CRP) in HIV and
HIV/HCV-co-infected individuals in the era of effective ART.
Methods: CRP levels were measured in 1135
HIV-infected participants from the fat redistribution and metabolic change in
HIV Infection (FRAM) cohort and 281 FRAM controls from the Coronary Artery Risk
Development in Young Adults (CARDIA) study. Multivariable linear regression
analyses were used to estimate the associations of HIV and HIV/HCV infection
with CRP levels.
Results : After multivariable analysis, compared
with controls, HIV mono-infection was associated with 88% higher CRP level in
men (p <0.0001), but little difference in women (5%, p =
0.80). There was no substantial association of CRP levels with ART, HIV RNA, or
CD4 cell count. Compared with controls, HIV/HCV co-infection was associated
with 41% lower CRP level in women (p = 0.012), but little difference in
men (+4%, p = 0.90). Among HIV-infected, HCV-co-infection was associated
with 50% lower CRP levels after multivariable analysis (p <0.0001) in
both men and women.
Conclusions: In the absence of HCV co-infection, HIV
infection is associated with higher CRP levels in men. HCV co-infection is
associated with lower CRP levels in both men and women, perhaps by suppressing
production. Our data raise the question as to whether CRP will predict
cardiovascular disease risk differently among patients with HCV or HIV/HCV co-infection.
|
