Endothelial activation markers are linked to HIV status and are independent of antiretroviral therapy and lipoatrophy.

OBJECTIVES: To assess the association of inflammatory and endothelial activation biomarkers with the presence of lipoatrophy in HIV-infected subjects and to examine the role of HIV, antiretroviral therapy (ART), and metabolic parameters in endothelial activation and inflammation. DESIGN: Prospective, cross-sectional study including 4 groups: HIV+ on ART with HIV-1 RNA<1000 copies/mL with and without clinical lipoatrophy, HIV+ ART naive, and healthy controls. METHODS: We measured plasma levels of inflammatory cytokines (tumor necrosis factor-alpha, soluble tumor necrosis factor receptors I and II, interleukin-6, C-reactive protein, and myeloperoxidase) and endothelial activation markers (soluble intercellular and vascular cell adhesion molecules and von Willebrand factor). RESULTS: We enrolled 182 subjects. Limb fat and lipoatrophy status were not correlated with endothelial markers. Endothelial markers were higher in HIV+ ART naive when compared with healthy controls and with HIV+ on ART but were similar between HIV+ on ART and healthy controls. Neither endothelial nor inflammatory markers were correlated with HIV duration, CD4 count, lipids, glucose, or specific ART. Strong correlations were found between some inflammatory cytokines and endothelial markers. CONCLUSIONS: There is enhanced endothelial activation in ART naive, whereas HIV+ on ART has similar values to healthy controls. Lipoatrophy did not seem to affect endothelial activation. Results highlight a potential association between heightened inflammation and endothelial activation.