Coronary artery disease in persons with HIV without detectable viral replication

INTRODUCTION We aimed to determine the prevalence of coronary artery disease (CAD) in persons with HIV (PWH) and investigate if inflammatory markers including interleukin (IL)-6, IL-1β, and high sensitivity C-reactive protein (hsCRP) were associated with CAD. METHODS From the Copenhagen Comorbidity in HIV Infection (COCOMO) study, we included virologically suppressed PWH with a coronary CT angiography. Any atherosclerosis was defined as >0% stenosis and obstructive CAD was defined as ≥50% stenosis. RESULTS Among 669 participants (mean age 51 (±11) years, 89% men), 300 (45%) had atherosclerosis, and obstructive CAD was present in 119 (18%). Risk factors including age, male sex, hypertension, diabetes, smoking, dyslipidemia, time with HIV, and current protease inhibitor use were associated with any atherosclerosis and with obstructive CAD. IL-6 and hsCRP > 2 mg/L were associated with any atherosclerosis and with obstructive CAD in univariable analyses, but not after adjusting for traditional risk factors. IL-1β was not associated with CAD. CONCLUSIONS In a large population of PWH without viral replication, almost half had angiography-verified atherosclerosis. High concentrations of IL-6 and hsCRP were univariably associated with CAD but adjusting for cardiovascular risk factors attenuated the association suggesting that inflammation may mediate the association between traditional risk factors and CAD.