Cardiovascular Risk Factors and Cardiac Biomarkers in Veterans Living with HIV and Uninfected Individuals Open Access

Abstract

Background: Non-communicable diseases have increased in people living with HIV; in particular, the risk of developing cardiovascular disease is two-fold higher in HIV-positive individuals.

Methods: Forty HIV-positive participants and uninfected individuals were recruited from the Atlanta VA Medical Center. Cardiovascular risk factors were collected through physical exams and paper questionnaires, and the following biomarkers were measured: high-sensitivity C-reactive protein (hsCRP), galectin-3, amino terminal propeptide of B-type natriuretic peptide (NT-proBNP), troponin T (TnT), and 3-nitrotyrosine (3-NT). Cardiovascular health was defined using the American Heart Association’s Life’s Simple 7. Multivariable logistic regression and multiple linear regression was conducted to evaluate the association of HIV infection status with risk factors and biomarkers of interest.

Results: HIV-positive participants on average scored 1.7 points higher (95% confidence interval: 0.9, 2.4) than uninfected individuals for the measure of overall cardiovascular health. HIV-positive participants were more likely to report a history of smoking and moderate exercise and less likely to report being a current smoker, use of medications for cholesterol, and use of medications for blood pressure. Additionally, HIV-positive participants had higher concentrations of hsCRP, galectin-3, and TnT values, and lower NT-proBNP and 3-NT values; however, these findings were not statistically significant.

Conclusions: In general, HIV-positive participants had better levels of cardiovascular health than uninfected individuals; however, biomarker results indicate a potentially greater risk for cardiovascular disease in the future.

Table of Contents

ABSTRACT 1

INTRODUCTION 2

METHODS 3

Study Population and Procedure 3

Cardiovascular Risk Factor and Covariate Ascertainment 5

Cardiac Biomarker Ascertainment 6

Statistical Analysis 7

RESULTS 8

DISCUSSION 11

FUNDING 14

REFERENCES 15

TABLES 19

Table 1. Demographic and Clinical Characteristics of Study Participants Overall and by HIV Status 19

Table 2. Estimated Odds Ratios (OR) and 95% Confidence Intervals (CI) for the Association of HIV with Cardiovascular Risk Factors in Study Participants, Controlling for Age, Sex, and Race 20

Table 3. Cardiovascular Biomarker Results for Study Participants Overall and by HIV Status 21

Table 4. Multiple Linear Regression Results for the Association of HIV with Cardiovascular Health and Cardiovascular Biomarkers in Study Participants, Controlling for Age, Sex, and Race 22

FIGURES 23

Figure 1. Recruitment Process Results for Eligible Participants 23

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	Veterans Cardiac Biomarker Human Immunodeficiency Virus Cardiovascular Disease
Committee Chair / Thesis Advisor	Alvaro Alonso, MD, PhD, Emory University
Partnering Agencies	US (Federal) agency other than CDC

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