Effect of antiretroviral therapy on inflammatory biomarkers of endothelial dyscfunction in HIV naïve infected patients
J.A. Mata Marín1, J.E. Gaytán-Martínez1, I.D.J. Ascencio-Montiel2, A.R. Mendez-Cruz3, C.I. Arroyo-Anduiza4, J. Asbun-Bojalil5
1IMSS 'La Raza' National Medical Center, Infectious Diseases, Mexico City, Mexico, 2IMSS 'La Raza' National Medical Center, Epidemiology Department, Mexico City, Mexico, 3IMSS 'La Raza' National Medical Center, Internal Medicine, Mexico City, Mexico, 4IMSS 'La Raza' National Medical Center, Clinical Pathology, Mexico City, Mexico, 5Instituto Politécnico Nacional, Escuela Superior de Medicina, Mexico City, Mexico
Background: Endothelial cell activation leads to increased expression of inflammatory cytokines and adhesion molecules. Levels increase in association with cardiovascular risk factors have been associated with structural and functional measures of atherosclerotic disease, as well as with adverse cardiovascular prognosis.
Methods: We performed a prospective cohort study in HIV naïve infected patients taking care at “La Raza” National Medical Center, Mexico City. Subjects were analyzed in a non-treatment group (NTG) and treatment group (TG) according to the therapeutic strategy received. Patients in TG received Efavirenz or Lopinavir- ritonavir, each with zidovudine/lamivudine. HIV viral load (copies/ml), CD4+ cell counts, hsCRP, sCD40L, sICAM-1, sVCAM-1 and sE-selectine were measured at beginning of study and 12 weeks after. We calculated paired t test, considering p-value < 0.05 statistical significant.
Results: We enrolled 50 subjects, 13 in NTG and 37 in TG, 48 (96%) completed follow up. The mean (± SD) age of our subjects was 33 ± 9 years and 38 (79%) were male. Basal CD4+ cells count was 698 ± 314 in NTG 273 ± 212 in TG; HIV viral load was 68,651 ± 116,936 in TG and 260,165 ± 311,819 in NTG. Comparing basal measurements to 12 weeks, TG had a decrease in endothelia inflammatory biomarkers sVCAM-1 (3169 ± 1395 vs 2219 ± 1218, p=0.001), sICAM-1 (902 ± 331 vs 705 ± 331, p=0.002) and sCD40L (9.1 ± 9.7 vs 6.4 ± 6.5, p=.026) at 12 weeks. No differences were observed in NTG. We found that there was a significant mild, positive correlation between HIV viral load and sICAM-1 (Pearson correlation coefficient = 0.324, p = 0.05).
Conclusion: Antiretroviral therapy is associated with a decrease in sVCAM-1, sICAM-1 and sCD40L after 12 weeks of treatment. There is a mild positive correlation between HIV viral load and sICAM-1.
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