1. High-sensitivity C-reactive protein levels in HIV-infected patients treated or not with antiretroviral drugs and their correlation with factors related to cardiovascular risk and HIV infection
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Guimarães, Milena Maria Moreira, Greco, Dirceu Bartolomeu, Figueiredo, Sônia Maria de, Fóscolo, Rodrigo Bastos, Oliveira, Antônio Ribeiro de, and Machado, Lucas José de Campos
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CARDIOVASCULAR diseases risk factors , *HIV-positive persons , *HIV infections , *THERAPEUTICS , *C-reactive protein , *ANTIRETROVIRAL agents , *METABOLIC syndrome , *MULTIVARIATE analysis - Abstract
Abstract: Aims: To compare high-sensitivity C-reactive protein (hsCRP) in HIV-infected patients treated or not with antiretroviral (ARV) drugs and to correlate hsCRP levels with traditional cardiovascular risk factors and parameters of HIV infection. Methods: One hundred and seventy-one HIV-infected patients were included (129 ARV-treated and 42 ARV-naïve). Evaluations included anthropometric measurements, blood pressure, laboratory tests, ultrasonographic measurement of fat thickness and impedance analysis. Results: hsCRP levels were higher in ARV-treated compared to ARV-naïve patients (p <0.001). Seventy-two (56%) ARV-treated patients and 11 (26%) ARV-naïve patients had hsCRP concentrations >3mg/dl (high risk for cardiovascular complications) (OR 3.56; 95%CI: 1.55–8.29; p =0.001, χ 2 test). hsCRP levels correlated positively with waist measurement (p =0.004), waist-to-hip ratio (p <0.001), systolic (p =0.05) and diastolic (p =0.03) blood pressure, intra-abdominal fat thickness (p =0.02), triglycerides (p =0.001), total cholesterol (p =0.01), fasting glucose (p =0.01), and glucose (p <0.001) and insulin levels (p =0.02) measured 2h after load. No correlation was found between hsCRP levels and CD4 cell counts and HIV-viral load. Independent factors associated with hsCRP levels were therapy with current non-nucleoside reverse transcriptase inhibitors (NNRTI) (p =0.003), waist-to-hip ratio (p =0.006), fasting glucose (p =0.049) and glucose levels 2h after load (p =0.003) in multivariate analysis model 1 and current NNRTI therapy (p <0.001), protease inhibitor therapy (p =0.016) and cardiometabolic syndrome (p =0.022) in multivariate analysis model 2. Conclusion: hsCRP in HIV-infected patients is associated with traditional cardiovascular risk factors, principally in ARV-treated patients. hsCRP levels are not associated with CD4 cell counts and HIV-viral load and may constitute a marker for cardiovascular risk related to HIV infection and ARV therapy. [Copyright &y& Elsevier]
- Published
- 2008
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