HIV and Cardiovascular Disease
Impact of Intestinal Microbiota on CVD Risks
Suman Srinivasa and colleagues described the association between a microbiota-derived precursor of TMAO, namely TMA, and coronary plaque.14
The study included 155 HIV positive individuals along with 67 HIV negative controls. Serum choline trimethylamine (TMA) and trimethylamine-N-oxide (TMAO) were assessed using mass-spectometry and cardiac CT angiography was used to assess coronary plaque. Among HIV positive patients, TMA was associated with number of plaques, calcified plaques, calcium score, plaque volume and mass and LPS. After adjustment for Framingham risk score, TMA remained significantly associated with total, calcified, calcium score, plaque volume and mass. After additional adjustment for LPS, TMA remained associated with total plaque segments, calcium score, and plaque mass. There was no association of TMAO to plaque in contrast.
Trimethylamine-N-oxide (TMAO) is metabolised by intestinal microbiota from dietary lipids. In HIV negative people, TMAO levels are associated with cardiovascular events.
Arjun Sinha and colleagues evaluated TMAO levels and carotid IMT in a small study from UCSF.15
The median TMAO levels were similar among HIV patients and controls; however, TMAO levels between HIV patients were similar to HIV negative patients with CAD. Traditional risk factors along with current ARV were associated with higher TMAO levels and TMAO was weakly associated with carotid IMT.
In summary, HIV and cardiovascular diseases were an expanding arena of investigation at CROI 2015.
The emphasis this year was on statin interventions, evaluation of the new ACC/AHA cholesterol guidelines in HIV, abacavir and risk of MI, comparison of risk calculators in HIV, and new markers of CV risk such as TMAO.
New event driven studies such as REPRIEVE and other smaller proof of concept studies designed to target inflammation in HIV are ongoing and NHLBI along with NIAID is committed to supporting studies in HIV with dedicated funding for HIV-related investigations.
Hsue P. HIV and Cardiovascular Disease: Report from 2015 CROI. natap.org. The full report includes additional slides and tables. This article in HTB was lightly edited for a print format.
Unless stated otherwise, all references are to the Programme and Abstracts of the 2015 Conference on Retroviruses and Opportunistic Infections (CROI 2015), 23-26 February 2015, Seattle.
Links to other websites are current at date of posting but not maintained.
This article was provided by HIV i-Base. It is a part of the publication HIV Treatment Bulletin. Visit HIV i-Base's website to find out more about their activities, publications and services.
Add Your Comment:
(Please note: Your name and comment will be public, and may even show up in
Internet search results. Be careful when providing personal information! Before
adding your comment, please read TheBody.com's Comment Policy.)
The content on this page is free of advertiser influence and was produced by our editorial team. See our content and advertising policies.