Abstract 11546: Role of Natural Autoantibodies Among Ugandans With Rheumatic Heart Disease and HIV
Introduction: Rheumatic heart disease (RHD) and HIV are prevalent diseases in sub-Saharan Africa associated with distinct immune dysregulatory abnormalities, but little is known about their potential interrelationships. Among naturally arising autoantibodies to oxidation-associated neo-determinants studied in other clinical populations, higher levels of IgM anti-phosphorylcholine (PC) correlate with protection from atherosclerotic CV and inflammatory diseases, while higher levels of IgG anti-malondialdehyde (MDA) instead correlate with greater autoimmune disease activity. The objective of this study was to assess the prevalence of natural autoantibodies among patients with and without RHD in Uganda, and to determine whether the levels of these natural autoantibodies among patients with RHD are affected by HIV status.
Methods: In this cross-sectional study, we grouped patients according to RHD and HIV status. The three control groups (RHD- HIV-, RHD- HIV+, RHD+ HIV-) were age-matched to the RHD+ HIV+ participants. All participants underwent echocardiography, HIV testing, and venous blood draw. IgM anti-PC and IgG anti-MDA were measured from frozen serum using ELISA.
Results: Overall, we enrolled 220 participants; 21 with both RHD and HIV. Ages ranged from 10 to 60 years, most being female (64%). After adjusting for age and gender, HIV infection and RHD were each associated with low IgM anti-PC (HIV: p<.0001 and RHD: p=.01). The figure shows median levels of IgM anti-PC by group. A significant HIV*RHD interaction was identified for IgG anti-MDA (p=.049) such that HIV infection was associated with increased IgG anti-MDA in participants without RHD, whereas it was associated with decreased IgG anti-MDA in participants with RHD.
Conclusions: This is the first study of natural autoantibody responses in patients with RHD. HIV appears to alter natural autoantibody levels potentially increasing risk for atherosclerosis and impacting the pathogenesis of RHD.
Author Disclosures: D.M. Huck: None. E. Okello: None. G. Mirembe: None. I. Ssinabulya: None. D.A. Zidar: None. G.J. Silverman: None. L. Getu: None. A.S. Nowacki: None. L.H. Calabrese: None. R.A. Salata: None. C.T. Longenecker: None.
- © 2015 by American Heart Association, Inc.