Association of Residual Plasma Viremia and Intima-Media Thickness in Antiretroviral-Treated Patients with Controlled Human Immunodeficiency Virus Infection

作者：Boyd Anders^*; Meynard Jean Luc; Morand Joubert Laurence; Michon Adrien; Boccara Franck; Bastard Jean Philippe; Samri Assia; Haddour Nabila; Mallat Ziad; Capeau Jacqueline; Desvarieux Moise; Girard Pierre Marie

来源：PLos One, 2014, 9(11): e113876.

DOI：10.1371/journal.pone.0113876

Background: While residual plasma viremia is commonly observed in HIV-infected patients undergoing antiretroviral treatment (ART), little is known about its subclinical consequences. %26lt;br%26gt;Methods: This cross-sectional study included 47 male, never-smoking, non-diabetic patients with %26gt;= 4 years of ART and controlled HIV-replication (HIV-viral load, VL %26lt;20 copies/mL for %26gt;= 1 year). Residual HIV-VL was measured using an ultrasensitive assay (quantification limit: 1 copy/ml). Patients were categorized as having detectable (D; 1-20 copies/mL, n=14) or undetectable (UD; %26lt;1 copies/mL, n=33) HIV-VL. Linear regression was used to model the difference in total carotid intima-media thickness [c-IMT, measures averaged across common carotid artery (cca), bifurcation, and internal carotid artery] and cca-IMT alone across detection groups. Multivariable models were constructed for each endpoint in a forward-stepwise approach. %26lt;br%26gt;Results: No significant differences were observed between viremia groups with respect to median ART-duration (9.6 years, IQR=6.8-10.9), nadir CD4+T-cell (208/mm(3), IQR=143-378), and CD4+T-cell count (555/mm(3), IQR=458-707). Median adjusted inflammatory markers tended to be higher in patients with D-than UD-viremia, with differences in IL-10 being significant (p=0.03). After adjustment on age, systolic blood pressure, and insulin resistance, mean cca-IMT was significantly lower in patients with undetectable (0.668 mm +/- 0.010) versus detectable viremia (0.727 mm +/- 0.015, p=0.002). Cca-IMT was also independently associated with age and insulin resistance. Mean adjusted total c-IMT was no different between viremia groups (p=0.2), however there was large variability in bifurcation c-IMT measurements. %26lt;br%26gt;Conclusions: Higher cca-IMT was observed in patients with detectable, compared to undetectable, HIV-VL in never-smoking ART-controlled patients, suggesting that residual HIV viremia may be linked to atherosclerosis.

• 出版日期2014-11-21