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Gustavo Castro
Kevin León
Damariz Marín-Palma
Sarita M. Oyuela
Jhon Ubeimar Cataño-Bedoya
Julieta Duque-Botero
Diana Patricia Giraldo-Méndez
Natalia A. Taborda
Juan C. Hernandez
María Teresa Rugeles
Fabián Alberto Jaimes

Introducción: la infección por VIH-1 induce una respuesta inflamatoria crónica exacerbada que desencadena alteraciones metabólicas y cardiovasculares; sin embargo, algunos individuos “controladores” no presentan los marcadores de progresión típicos. Dado que las pruebas que evaluan el riesgo cardiovascular carecen de precisión en pacientes con VIH-1, el estudio de parámetros inflamatorios en individuos con diferente progresión podría aportar a la definición de predictores de enfermedad cardiovascular en esta población. El objetivo es explorar diferencias y correlaciones en biomarcadores metabólicos e inflamatorios asociados con riesgo cardiovascular, comparando individuos controladores y progresores con y sin terapia antiviral. Materiales y métodos: estudio analítico transversal con 63 individuos infectados por VIH-1, clasificados en controladores y progresores (con terapia antiviral y sin esta), y controles sanos. Se midió el grosor de la íntima media carotidea (CIMT), puntajes de riesgo cardiovascular y cuantificación de perfil lipídico, glucemia en ayunas, PCR ultrasensible, dímero D, sCD14, sCD163, il-6 e il-18. Se realizó comparación por Anova o Kruskal-Wallis y correlación por coeficiente de Spearman. Resultados: no hubo diferencias significativas en índices de Framingham, DAD o CIMT, pero los individuos controladores presentaron menores valores de triglicéridos, comparados con los progresores. No se observaron diferencias en PCR ultrasensible, il-6, il-18, y sCD163, entre los grupos estudiados. La mediana del HDL fue mayor en los progresores con terapia antiviral y el CIMT en los controladores se correlacionó negativamente con sCD14. Conclusión: los individuos controladores presentan un perfil cardiovascular diferente a los individuos progresores, de acuerdo con los biomarcadores metabólicos e inmunológicos evaluados.

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Castro, G., León, K., Marín-Palma D. ., Oyuela, S. M. ., Cataño-Bedoya J. U. ., Duque-Botero, J., Giraldo-Méndez D. P. ., Taborda, N. A. ., Hernandez, J. C. ., Rugeles, M. T. ., & Jaimes, F. A. . (2021). Evaluación de la relación entre marcadores metabólicos, inmunológicos y de riesgo cardiovascular en pacientes con VIH-1. Revista Ciencias De La Salud, 19(3). https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.10532

Pelchen-Matthews A, Ryom L, Borges AH, Edwards S, Duvivier C, Stephan C, et al. Aging and the evolution of comorbidities among HIV-positive individuals in a European cohort. Aids. 2018;32(16):2405-16. https://doi.org/10.1097/QAD.0000000000001967

Antiretroviral Therapy Cohort C. Causes of death in HIV-1-infected patients treated with antiretroviral therapy, 1996-2006: collaborative analysis of 13 HIV cohort studies. Clin Infect Dis. 2010;50(10):1387-96. https://doi.org/10.1086/652283

Ingle SM, May MT, Gill MJ, Mugavero MJ, Lewden C, Abgrall S, et al. Impact of risk factors for specific causes of death in the first and subsequent years of antiretroviral therapy among HIV-infected patients. Clin Infect Dis. 2014;59(2):287-97. https://doi.org/10.1093/cid/ciu261

Sabin CA. Do people with HIV infection have a normal life expectancy in the era of combination antiretroviral therapy? BMC Med. 2013;11:251. https://doi.org/10.1186/1741- 7015-11-251

Kuller LH, Tracy R, Belloso W, De Wit S, Drummond F, Lane HC, et al. Inflammatory and coagulation biomarkers and mortality in patients with HIV infection. PLoS Med. 2008;5(10):e203. https://doi.org/10.1371/journal.pmed.0050203

Group DADS, Friis-Moller N, Reiss P, Sabin CA, Weber R, Monforte A, et al. Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med. 2007;356(17):1723-35. https://doi.org/10.1056/NEJMoa062744

Ounjaijean S, Kulprachakarn K, Aurpibul L, Kaewpoowat Q, Boonyapranai K, Chaiwarith R, et al. Cardiovascular risks in Asian HIV-infected patients receiving boosted-protease inhibitor-based antiretroviral treatment. J Infect Dev Ctries. 2021;15(2):289-96. https://doi.org/10.3855/jidc.12864

Estrada V, Martinez-Larrad MT, Gonzalez-Sanchez JL, de Villar NG, Zabena C, Fernandez C, et al. Lipodystrophy and metabolic syndrome in HIV-infected patients treated with antiretroviral therapy. Metabolism. 2006;55(7):940-5. https://doi.org/10.1016/j.metabol.2006.02.024

Kirkman MS, Mahmud H, Korytkowski MT. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes Mellitus. Endocrinol Metab Clin North Am. 2018;47(1):81-96. https://doi.org/10.1016/j.ecl.2017.10.002

Beraldo RA, Santos APD, Guimaraes MP, Vassimon HS, Paula FJA, Machado DRL, et al. Body fat redistribution and changes in lipid and glucose metabolism in people living with HIV/aids. Rev Bras Epidemiol. 2017;20(3):526-36. https://doi.org/10.1590/1980- 5497201700030014

Lang S, Mary-Krause M, Simon A, Partisani M, Gilquin J, Cotte L, et al. HIV replication and immune status are independent predictors of the risk of myocardial infarction in HIV-infected individuals. Clin Infect Dis. 2012;55(4):600-7. https://doi.org/10.1093/cid/cis489

O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK, Jr. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999;340(1):14-22. https://doi.org/10.1056/NEJM199901073400103

Petoumenos K, Reiss P, Ryom L, Rickenbach M, Sabin CA, El-Sadr W, et al. Increased risk of cardiovascular disease (CVD) with age in HIV-positive men: a comparison of the DAD CVD risk equation and general population CVD risk equations. HIV Med. 2014;15(10):595- 603. https://doi.org/10.1111/hiv.12162

Walker BD. Elite control of HIV infection: implications for vaccines and treatment. Top HIV Med. 2007;15(4):134-6.

Feria MG, Taborda NA, Hernandez JC, Rugeles MT. HIV replication is associated to inflammasomes activation, il-1beta, IL-18 and caspase-1 expression in galt and peripheral blood. PloS One. 2018;13(4):e0192845. https://doi.org/10.1371/journal.pone.0192845

Taborda NA, Rugeles MT, Montoya CJ. Spontaneous control of HIV replication, but not heart-induced viral suppression, is associated with lower activation of immune cells. J Acquir Immune Defic Syndr. 2014;66(4):365-9. https://doi.org/10.1097/ QAI.0000000000000162

Taborda NA, Gonzalez SM, Alvarez CM, Correa LA, Montoya CJ, Rugeles MT. Higher frequency of NK and CD4+ T-Cells in the mucosa and potent cytotoxic response in HIV controllers. PloS one. 2015;10(8):e0136292. https://doi.org/10.1371/journal.pone.0136292

Friis-Moller N, Thiebaut R, Reiss P, Weber R, Monforte AD, De Wit S, et al. Predicting the risk of cardiovascular disease in HIV-infected patients: the data collection on adverse effects of anti-HIV drugs study. Eur J Cardiovasc Prevent Rehab. 2010;17(5):491-501. https://doi.org/10.1097/HJR.0b013e328336a150

Muñoz OM, Rodríguez NI, Ruiz Á, Rondón M. Validación de los modelos de predicción de Framingham y procam como estimadores del riesgo cardiovascular en una población colombiana. Rev Colomb Cardiol. 2014;21(4):202-12. https://doi.org/10.1016/j.rccar.2014.02.001

Muñoz OM, García ÁA, Fernández-Ávila D, Higuera A, Ruiz ÁJ, Aschner P, et al. Guía de práctica clínica para la prevención, detección temprana, diagnóstico, tratamiento y seguimiento de las dislipidemias: evaluación del riesgo cardiovascular. Rev Colomb Cardiol. 2015;22(6):263-9. https://doi.org/10.1016/j.rccar.2015.04.009

Marin-Palma D, Castro GA, Cardona-Arias JA, Urcuqui-Inchima S, Hernandez JC. Lower high-density lipoproteins levels during human immunodeficiency virus type 1 infection are associated with increased inflammatory markers and disease progression. Front Immunol. 2018;9:1350. https://doi.org/10.3389/fimmu.2018.01350

Feinstein MJ, Bahiru E, Achenbach C, Longenecker CT, Hsue P, So-Armah K, et al. Patterns of cardiovascular mortality for HIV-infected adults in the United States: 1999 to 2013. Am J Cardiol. 2016;117(2):214-20. https://doi.org/10.1016/j.amjcard.2015.10.030

Mdodo R, Frazier EL, Dube SR, Mattson CL, Sutton MY, Brooks JT, et al. Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys. Ann Intern Med. 2015;162(5):335-44. https://doi. org/10.7326/M14-0954

Durand M, Chartrand-Lefebvre C, Baril JG, Trottier S, Trottier B, Harris M, et al. The Canadian HIV and aging cohort study-determinants of increased risk of cardiovascular diseases in HIV-infected individuals: rationale and study protocol. BMC Infect Dis. 2017;17(1):611. https://doi.org/10.1186/s12879-017-2692-2

Law M, Friis-Moller N, Weber R, Reiss P, Thiebaut R, Kirk O, et al. Modelling the 3-year risk of myocardial infarction among participants in the Data Collection on Adverse Events of Anti-HIV Drugs (DAD) study. HIV Med. 2003;4(1):1-10. https://doi.org/10.1046/j.1468- 1293.2003.00138.x

Thompson-Paul AM, Lichtenstein KA, Armon C, Palella FJ, Jr., Skarbinski J, Chmiel JS, et al. Cardiovascular Disease Risk Prediction in the HIV Outpatient Study. Clin Infect Dis. 2016;63(11):1508-16. https://doi.org/10.1093/cid/ciw615

Phan BAP, Weigel B, Ma Y, Scherzer R, Li D, Hur S, et al. Utility of 2013 American College of Cardiology/American Heart Association Cholesterol Guidelines in HIV-infected adults with carotid atherosclerosis. Circ Cardiovasc Imaging. 2017;10(7). https://doi.org/10.1161/ CIRCIMAGING.116.005995

Nsagha DS, Weledji EP, Assob NJ, Njunda LA, Tanue EA, Kibu OD, et al. Highly active antiretroviral therapy and dyslipidemia in people living with HIV/aids in Fako Division, South West Region of Cameroon. BMC Cardiovasc Dis. 2015;15:95. https://doi.org/10.1186/ s12872-015-0090-5

Hassan M, Philip P. CANHEART: is HDL cholesterol a cardiovascular specific risk factor? Glob Cardiol Sci Pract. 2016;2016(4):e201634. https://doi.org/10.21542/gcsp.2016.34

Araujo S, Banon S, Machuca I, Moreno A, Perez-Elias MJ, Casado JL. Prevalence of insulin resistance and risk of diabetes mellitus in HIV-infected patients receiving current antiretroviral drugs. Eur J Endocrinol. 2014;171(5):545-54. https://doi.org/10.1530/EJE-14-0337

Hanna DB, Lin J, Post WS, Hodis HN, Xue X, Anastos K, et al. Association of macrophage inflammation biomarkers with the progression of subclinical carotid artery atherosclerosis in HIV-infected women and men. J Infect Dis. 2017;215(9):1352-61. https://doi.org/10.1093/infdis/jix082

Iannello A, Boulassel MR, Samarani S, Tremblay C, Toma E, Routy JP, et al. HIV-1 causes an imbalance in the production of interleukin-18 and its natural antagonist in HIV-infected individuals: implications for enhanced viral replication. J Infect Dis. 2010;201(4):608-17. https://doi.org/10.1086/650314

Marin-Palma MD, Cardona-Arias MJA, Hernández SDJC. Factores inmunológicos relacionados con VIH-1 en pacientes colombianos. Rev Cienc Salud. 2019;17(2). https://doi. org/10.12804/revistas.urosario.edu.co/revsalud/a.7927

Sereti I, Krebs SJ, Phanuphak N, Fletcher JL, Slike B, Pinyakorn S, et al. Persistent, albeit reduced, chronic inflammation in persons starting antiretroviral therapy in acute HIV infection. Clin Infect Dis. 2017;64(2):124-31. https://doi.org/10.1093/cid/ciw683

Rugeles-López MT, Oyuela-Gómez SM, Castro-Torres GA, Jaimes-Barragán FA. Biomarcadores inmunológicos de riesgo cardiovascular en la infección por el virus de inmunodeficiencia humana-1. Rev Colomb Cardiol. 2017;24(2):153-60. https://doi. org/10.1016/j.rccar.2016.05.012

Hanna DB, Post WS, Deal JA, Hodis HN, Jacobson LP, Mack WJ, et al. HIV infection is associated with progression of subclinical carotid atherosclerosis. Clin Infect Dis. 2015;61(4):640-50. https://doi.org/10.1093/cid/civ325

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