HIV and carotid atherosclerosis: a mediational model

ABSTRACT

Cardiovascular disease (CVD) is the leading cause of death in the US and is a significant contributor to morbidity and mortality for people living with HIV (PLWH). This study examined the association between HIV infection, cocaine usage, and inflammatory markers, and their combined association with carotid atherosclerosis among young and middle-aged adults with HIV. Participants (N = 494) were enrolled based on HIV status and cocaine use. Blood pressure, body mass index (BMI), and cocaine use were assessed. Cytokines and growth factors, IL-1a, IL-6, TNFα and VEGF, and immune activation markers, sCD14 and sCD163 were measured. Participant age was 36.2 years (SD = 9.5); 50% were male, 49% female and 1% transgender; 39% were HIV-positive, 50% were current or past smokers, and 39% endorsed cocaine use. A path analysis showed an indirect effect of HIV serostatus on the presence of carotid atherosclerotic plaques (Indirect Effect = 0.048, SE = 0.024, p = .043), when controlling age, BMI, smoking, and cocaine use. This effect was mediated by inflammatory markers and changes in blood pressure. Findings point to putative underlying mechanisms leading to atherosclerosis among PLWH.

KEYWORDS:

• Atherosclerosis
• inflammation
• immune activation
• HIV
• cocaine

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by a grant from NIDA/NIH, R01DA034589, and with support from the Miami Center for AIDS Research, NIAID/NIH grant P30AI073061. This work was also partially funded by a Ford Foundation Fellowship to Violeta J. Rodriguez, administered by the National Academies of Sciences, Engineering, and Medicine.