Dataset Information

Increased risk of radiographic emphysema in HIV is associated with elevated soluble CD14 and nadir CD4.

ABSTRACT:

Background

The association between HIV and emphysema remains incompletely understood. We sought to determine whether HIV is an independent risk factor for emphysema severity and whether markers of HIV severity and systemic biomarkers of inflammation (IL-6), altered coagulation (D-dimer), and immune activation (soluble CD14) are associated with emphysema.

Methods

We performed a cross-sectional analysis of 114 participants with HIV infection and 89 participants without HIV infection in the Examinations of HIV-Associated Lung Emphysema (EXHALE) study. Participants underwent chest CT imaging with blinded semiquantitative interpretation of emphysema severity, distribution, and type. We generated multivariable logistic regression models to determine the risk of HIV for radiographic emphysema, defined as > 10% lung involvement. Similar analyses examined associations of plasma biomarkers, HIV RNA, and recent and nadir CD4 cell counts with emphysema among participants with HIV infection.

Results

Participants with HIV infection had greater radiographic emphysema severity with increased lower lung zone and diffuse involvement. HIV was associated with significantly increased risk for > 10% emphysema in analyses adjusted for cigarette smoking pack-years (OR, 2.24; 95% CI, 1.12-4.48). In multivariable analyses restricted to participants with HIV infection, nadir CD4 < 200 cells/?L (OR, 2.98; 95% CI, 1.14-7.81), and high soluble CD14 level (upper 25th percentile) (OR, 2.55; 95% CI, 1.04-6.22) were associated with increased risk of > 10% emphysema. IL-6 and D-dimer were not associated with emphysema in HIV.

Conclusions

HIV is an independent risk factor for radiographic emphysema. Emphysema severity was significantly greater among participants with HIV infection. Among those with HIV, nadir CD4 < 200 cells/?L and elevated soluble CD14 level were associated with emphysema, highlighting potential mechanisms linking HIV with emphysema.

SUBMITTER: Attia EF

PROVIDER: S-EPMC4251616 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Publications

Increased risk of radiographic emphysema in HIV is associated with elevated soluble CD14 and nadir CD4.

Attia Engi F EF Akgün Kathleen M KM Wongtrakool Cherry C Goetz Matthew Bidwell MB Rodriguez-Barradas Maria C MC Rimland David D Brown Sheldon T ST Soo Hoo Guy W GW Kim Joon J Lee Patty J PJ Schnapp Lynn M LM Sharafkhaneh Amir A Justice Amy C AC Crothers Kristina K

Chest 20141201 6

<h4>Background</h4>The association between HIV and emphysema remains incompletely understood. We sought to determine whether HIV is an independent risk factor for emphysema severity and whether markers of HIV severity and systemic biomarkers of inflammation (IL-6), altered coagulation (D-dimer), and immune activation (soluble CD14) are associated with emphysema.<h4>Methods</h4>We performed a cross-sectional analysis of 114 participants with HIV infection and 89 participants without HIV infection ...[more]

PMID: 25080158

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Project description:ObjectivesHIV-infected population may have increased risk of cardiovascular disease. The prevalence of traditional cardiovascular disease risk factors such as hypertension, diabetes and dyslipidemia in HIV-infected individuals has made it difficult to assess the direct effects of HIV and immune factors on endothelial dysfunction and associated increased risk of atherosclerosis. The purpose of this study was to investigate indicators of endothelial dysfunction in an HIV cohort without hypertension and diabetes.MethodsWe studied 19 HIV-infected patients between the ages of 25-76?years old with effectively suppressed viral load and without diagnosis of hypertension or diabetes. Endothelial function was measured by digital thermal monitoring of vascular reactivity using the VENDYS technique. Endothelial function was reported as vascular reactivity index. Systolic blood pressure and diastolic blood pressure at the time of VENDYS test were measured and latest lipid panels were recorded. The association between vascular reactivity index and CD4-T cells count, different antiretroviral therapy types (non-nucleoside reverse transcriptase, nucleoside reverse transcriptase, protease inhibitors, integrase inhibitors), vitamins use, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol was investigated.ResultsMean vascular reactivity index was 1.87?±?0.53. Vascular reactivity index, marker of endothelial dysfunction, showed a significant correlation with lower nadir CD4 count (p?=?0.003) as well as low-density lipoprotein cholesterol (p?=?0.02). No additional significant correlation between vascular reactivity index and the rest of the investigated variables was found.ConclusionVascular reactivity index, a clinical predictor of endothelial dysfunction, is associated with lower nadir CD4-T cell and low-density lipoprotein cholesterol in HIV-infected men with no history of hypertension or diabetes and before clinical evidence of cardiovascular disease.

Dataset Information

Increased risk of radiographic emphysema in HIV is associated with elevated soluble CD14 and nadir CD4.

Background

Methods

Results

Conclusions

Publications

Increased risk of radiographic emphysema in HIV is associated with elevated soluble CD14 and nadir CD4.

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