Abstract 12584: Epicardial and Thoracic Peri-aortic Adipose Tissue are Associated with Biomarkers of Inflammation and Immune Activation in HIV-infected Patients on Antiretroviral Therapy
Background: HIV-infection is characterized by chronic immune activation that persists despite effective antiretroviral therapy (ART) and is associated with elevated cardiovascular risk. Whether specific vascular fat depots are associated with inflammation in HIV is unknown.
Methods: Baseline epicardial (EAT) and thoracic peri-aortic (TAT) adipose tissue volume were measured by computed tomography in the first 115 subjects enrolled in the Stopping Atherosclerosis and Treating Unhealthy bone with RosuvastatiN in HIV (SATURN-HIV) trial. All subjects were adults, on stable ART, with LDL-cholesterol ≤130mg/dL and evidence of heightened T cell activation (CD8+CD38+HLA-DR+ ≥19%) or increased inflammation (high sensitivity C-reactive protein ≥2mg/L).
Results: Overall, 76% were male and 70% African-American. Median (IQR) age and body mass index were 47 (42, 53) years and 27 (24, 31) kg/m2, respectively. All subjects had HIV-1 RNA <1,000 copies/mL with median (IQR) CD4+ T cell count of 631 (455, 837) cells/µL; 50% were on a protease inhibitor. Log transformed EAT and TAT were correlated with each other (Spearman’s r=0.78, p<0.0001) and with coronary artery calcium score (r=0.19, p=0.04 and r=0.25, p=0.006 respectively). Both were associated with Framingham risk, atherogenic lipid profile, insulin resistance, total and central body fat, and serum biomarkers of inflammation, but not with cellular markers of lymphocyte or monocyte activation (Table 1). Compared to subjects in the lowest quartile, subjects in the highest quartile of EAT had 3.9-fold higher interleukin-6 levels (p=0.008) and 1.6-fold higher soluble tumor necrosis factor-alpha receptor levels (p=0.0006).
Conclusions: EAT and TAT are associated with several markers of inflammation in this population of virologically suppressed HIV-infected patients on ART. The effect of statins on fat volumes and inflammation will be tested in the ongoing trial.
- © 2012 by American Heart Association, Inc.