Infectious Disease · Cardiology · 2 h ago
Endothelial Biomarker Abnormalities Persist Despite Antiretroviral Therapy Initiation During Acute HIV
An observational study measured 13 vascular and hemostatic biomarkers in 83 people treated during acute HIV infection, with 32 people without HIV as comparators. Several abnormalities persisted at week 288 despite suppressive therapy; an endothelial activation phenotype occurred in 45% versus 13%, respectively.
- Researchers measured 13 biomarkers in 83 participants with acute HIV.
- Some endothelial abnormalities persisted through week 288 despite suppressive ART.
- Activation phenotype occurred in 45% with HIV versus 13% without.
- Biomarker findings do not establish increased cardiovascular event rates.
An observational analysis of the RV254 acute HIV cohort examined whether endothelial and hemostatic abnormalities emerge early and persist after immediate antiretroviral therapy (ART). Researchers measured 13 plasma biomarkers in 83 participants before ART and at week 288, comparing them with cross-sectional measurements from 32 people without HIV. Hierarchical clustering assessed biomarker phenotypes at week 288.
Before ART, ICAM-1, VCAM-1, tissue factor, neopterin, and myeloperoxidase were higher in participants with HIV, independent of age, sex, and body mass index (P < .05). These markers correlated with HIV RNA or the CD4/CD8 ratio. By week 288, several markers had declined significantly, including ICAM-1 and VCAM-1. Nevertheless, VCAM-1 and thrombomodulin remained higher, and VEGF-A remained lower, than in comparators (P < .05).
Clustering identified a phenotype with concomitant elevations in ICAM-1, ICAM-2, VCAM-1, and E-selectin in 45% of participants with HIV versus 13% of comparators, despite comparable estimated 10-year cardiovascular risk between clusters. The findings suggest persistent endothelial activation despite suppressive ART initiated during acute infection. However, the small observational study assessed biomarkers rather than cardiovascular events, and comparator measurements were cross-sectional. The abstract does not establish whether these profiles predict clinical outcomes or warrant changes in management.
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The Journal of Infectious Diseases: Soluble Indicators of Endothelial Injury and Activation Emerge During Acute HIV Infection and Persist Despite Rapid Antiretroviral Therapy Initiation ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.