Abstract 15501: Elevated Levels of Monocyte Activation Markers, Soluble CD14 and CD163, are Associated With Subclinical Atherosclerosis in the Multicenter AIDS Cohort Study (MACS)
Background: We previously demonstrated higher prevalence and extent of non-calcified coronary plaque in HIV-infected men. Levels of pro-inflammatory monocytes may be elevated in HIV infection and associated with atherosclerosis. We tested the associations between soluble CD163 and CD14 with subclinical coronary atherosclerosis in HIV seropositive (SP) and seronegative (SN) men in the MACS.
Methods: We measured soluble CD163 and CD14 and CAD risk factors and performed non-contrast CT scans to evaluate CAC in 521 HIV SP and 270 SN men, age 40-70. Coronary CT angiogram was performed on 391 HIV SP and 223 SN men to measure non-calcified plaque score (NCPS), total plaque score (TPS) and coronary stenosis. Logistic regression tested for associations between plaque presence (score > 0) and each biomarker. Linear regression tested for associations between extent of plaque among men with plaque present. Models were adjusted for age, race, and CAD risk factors. CD163 levels were log transformed. Tests for interaction by HIV serostatus were performed.
Results: CD163 and CD14 levels were higher in SP than SN men (718 ± 257 vs 582 ± 204; 1688 ± 461 vs 1310 ± 324 ng/ml, both p<0.001), even though 81% of SP had viral suppression on highly active antiretroviral therapy (HAART). Both CD163 and CD14 levels were positively associated with CAC presence (OR = 1.69, p = 0.02; OR = 1.04, p = 0.049), CAC extent (beta = 0.71, p = 0.003; beta = 0.05, p = 0.007) and with presence of coronary stenosis >50% (OR = 1.97, p = 0.047; OR = 1.10, p = 0.003). CD14 levels were associated with greater plaque extent on CT angiography, as measured by TPS (beta=0.03, p<0.003). There were no interactions by HIV status for those associations, but CD163 levels were associated with plaque extent only in SP men (beta=0.25, p=0.04; SN beta= -0.15, p=0.43; interaction p=0.03). There were no associations between CD163 and CD14 with plaque presence on CT angiography (TPS>0) or with presence or extent of NCP.
Conclusions: CD163 and CD14 levels, markers of monocyte activation, are elevated among HIV-infected men and associated with subclinical atherosclerosis and stenosis. These results suggest that monocyte activation may play a role in the development of coronary atherosclerosis in HIV infection despite treatment with HAART.
- © 2013 by American Heart Association, Inc.