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. 2009 Dec 1;52(4):480-7.
doi: 10.1097/qai.0b013e3181b939e5.

Highly sensitive C-reactive protein, body mass index, and serum lipids in HIV-infected persons receiving antiretroviral therapy: a longitudinal study

Michael S Boger  1 , Ayumi Shintani, Leigh Anne Redhage, Valerie Mitchell, David W Haas, Jason D Morrow, Todd Hulgan
Affiliations

Highly sensitive C-reactive protein, body mass index, and serum lipids in HIV-infected persons receiving antiretroviral therapy: a longitudinal study

Michael S Boger et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Antiretroviral therapy (ART) affects cardiovascular disease (CVD) risk. In the general population, highly sensitive creactive protein (hsCRP) is an established predictor of future coronary events. Little is known about its utility in chronic inflammatory conditions such as HIV infection. We assessed relationships between hsCRP and metabolic parameters over time in HIV-infected patients on ART.

Methods: Data are from a prospective cohort of HIV-infected adults enrolled June 2005 to July 2007. Participants were receiving ART, had HIV-1 RNA,10,000 copies per milliliter, and no diabetes or CVD. Nonlinear mixed-effect regression models assessed relationships between body mass index (BMI), lipids, and hsCRP over time adjusting for covariates.

Results: Ninety-four individuals had data from $1 study visit. Median age was 44 years, 27% were female, 57% white, and 54% were on protease inhibitors. Median CD4+ T cells, HIV-1 RNA, and hsCRP were 502 cells per cubic millimeter, 50 copies per milliliter, and 2.94 mg/dL, respectively. Median Framingham score was 3. Multivariate analysis identified associations between increased hsCRP and greater BMI (P = 0.001), higher non-high-density lipoprotein cholesterol (P = 0.013) and triglycerides (P = 0.017), and lower high-density lipoprotein cholesterol (P = 0.015).

Conclusions: Among HIV-infected adults with low estimated CVD risk and virologic suppression on ART, hsCRP was elevated and independently associated with BMI and lipid changes. Future studies should assess associations between hsCRP and clinical outcomes.

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Conflict of interest statement

Conflict of interest disclosure: MS Boger-no conflict, A Shintani-no conflict, LA Redhage-no conflict, V Mitchell-no conflict, DW Haas-no conflict, JD Morrow-no conflict, and T Hulgan-no conflict.

Figures

Figure 1
Figure 1
Association of (A) LDL cholesterol, (B) Non-HDL cholesterol, (C) HDL cholesterol, (D) triglycerides, and (E) BMI with hsCRP. Data are reverse-log-transformed from multivariable repeated measures analysis adjusting for sex, race, age, smoking status, fasting state, CD4+ T cells, HIV-1 RNA, and use of PIs and lipid-lowering therapy. Note: hsCRP = highly sensitive c-reactive protein, LDL = low-density lipoprotein, HDL = high-density lipoprotein, BMI = body mass index, PI = protease inhibitor, R = regression coefficient
Figure 1
Figure 1
Association of (A) LDL cholesterol, (B) Non-HDL cholesterol, (C) HDL cholesterol, (D) triglycerides, and (E) BMI with hsCRP. Data are reverse-log-transformed from multivariable repeated measures analysis adjusting for sex, race, age, smoking status, fasting state, CD4+ T cells, HIV-1 RNA, and use of PIs and lipid-lowering therapy. Note: hsCRP = highly sensitive c-reactive protein, LDL = low-density lipoprotein, HDL = high-density lipoprotein, BMI = body mass index, PI = protease inhibitor, R = regression coefficient
Figure 1
Figure 1
Association of (A) LDL cholesterol, (B) Non-HDL cholesterol, (C) HDL cholesterol, (D) triglycerides, and (E) BMI with hsCRP. Data are reverse-log-transformed from multivariable repeated measures analysis adjusting for sex, race, age, smoking status, fasting state, CD4+ T cells, HIV-1 RNA, and use of PIs and lipid-lowering therapy. Note: hsCRP = highly sensitive c-reactive protein, LDL = low-density lipoprotein, HDL = high-density lipoprotein, BMI = body mass index, PI = protease inhibitor, R = regression coefficient
Figure 1
Figure 1
Association of (A) LDL cholesterol, (B) Non-HDL cholesterol, (C) HDL cholesterol, (D) triglycerides, and (E) BMI with hsCRP. Data are reverse-log-transformed from multivariable repeated measures analysis adjusting for sex, race, age, smoking status, fasting state, CD4+ T cells, HIV-1 RNA, and use of PIs and lipid-lowering therapy. Note: hsCRP = highly sensitive c-reactive protein, LDL = low-density lipoprotein, HDL = high-density lipoprotein, BMI = body mass index, PI = protease inhibitor, R = regression coefficient
Figure 1
Figure 1
Association of (A) LDL cholesterol, (B) Non-HDL cholesterol, (C) HDL cholesterol, (D) triglycerides, and (E) BMI with hsCRP. Data are reverse-log-transformed from multivariable repeated measures analysis adjusting for sex, race, age, smoking status, fasting state, CD4+ T cells, HIV-1 RNA, and use of PIs and lipid-lowering therapy. Note: hsCRP = highly sensitive c-reactive protein, LDL = low-density lipoprotein, HDL = high-density lipoprotein, BMI = body mass index, PI = protease inhibitor, R = regression coefficient
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