High-sensitivity C-reactive protein levels in HIV-infected patients treated or not with antiretroviral drugs and their correlation with factors related to cardiovascular risk and HIV infection

Aims: To compare high-sensitivity C-reactive protein (hsCRP) in HIV-infected patients treated or not with antiretroviral (ARV) drugs and to correlate hsCRP levels with traditional cardiovascular risk factors and parameters of HIV infection. Methods: One hundred and seventy-one HIV-infected patients were included (129 ARV-treated and 42 ARV-naive). Evaluations included anthropometric measurements, blood pressure, laboratory tests, ultrasonographic measurement of fat thickness and impedance analysis. Results: hsCRP levels were higher in ARV-treated compared to AR-naive patients (p<0.001). Seventy-two (56%) AR-treated patients and 11 (26%) ARV-naive patients had hsCRP concentrations >3 mg/dl (high risk for cardiovascular complications) (OR 3.56; 95%CI: 1.55-8.29; p=0.001, x(2) test). hsCRP levels correlated positively with waist measurement (p=0.004), waist-to-hip ratio (p<0.001), systolic (p=0.05) and diastolic (p=0.03) blood pressure, intra-abdominal fat thickness (p=0.02), triglycerides (p=0.001), total cholesterol (p=0.01), fasting glucose (p=0.01), and glucose (p<0.001) and insulin levels (p=0.02) measured 2h after load. No correlation was found between hsCRP levels and CD4 cell Counts and HIV-viral load. Independent factors associated with hsCRP levels were therapy with current non-nucleoside reverse transcriptase inhibitors (NNRT1) (p=0.003). waist-to-hip ratio (p=0.006), fasting glucose (p=0.049) and glucose levels 2h after load (p=0.003) in multivariate analysis model 1 and current NNRT1 therapy (p<0.001), protease inhibitor therapy (p=0.016) and cardiometabolic syndrome (p=0.022) in multivariate analysis model 2. Conclusion: hsCRP in HIV-infected patients is associated with traditional cardiovascular risk factors, principally in ARV-treated patients. hsCRP levels are not associated with CD4 cell counts and HIV-viral load and may Constitute a marker for cardiovascular risk related to HIV infection and ARV therapy. (C) 2008 Elsevier Ireland Ltd. All rights reserved.