Risk factors for cardiovascular disease increased in HIV-positive women
HIV-infected women have increased risk factors for the development of cardiovascular disease, United States researchers warn in the 1st May edition of The Journal of Acquired Immune Deficiency Syndromes. They report that most of these risk factors may be influenced primarily by abnormal body fat redistribution, rather than being a direct consequence of HIV infection or treatment.HIV infection and antiretroviral therapy are known to increase the risk of cardiovascular disease and to cause changes in body fat distribution, such as loss of fat from under the skin and increases in fat accumulation around the internal organs. This information was gathered from studies that included few women, leaving uncertainty surrounding whether these conclusions apply equally to both sexes. To redress this imbalance, investigators from Boston compared cardiovascular risk factors and body fat levels in 100 HIV-positive and 75 HIV-negative women recruited from hospital and community-based health care providers in Massachusetts. The two groups of women were similar in age, weight and racial composition. “This study demonstrates marked abnormalities in inflammatory and traditional cardiovascular disease risk indices in HIV-infected women,” they conclude. “Simple measures of body composition such as waist-to-hip ratio are strongly associated with abnormal biochemical indices in this population.”
The researchers measured levels of a range of chemical markers in the blood of the women, including traditional risk factors for cardiovascular disease, such as blood fat, glucose and insulin levels. They also assessed the levels of the newly discovered factors that are linked to inflammation of the blood vessels, including C-reactive protein (CRP), interleukin-6 (IL-6) and adiponectin. Levels of triglyceride fats in the blood were higher in the HIV-positive women (mean 1.84 vs. 0.85 mM, p < 0.001), as were glucose levels measured two hours after the women drank a glucose solution (81 vs. 45 pM, p < 0.001). Both of these factors are associated with an increased risk of cardiovascular disease. The HIV-positive women also had higher levels of insulin after an overnight fast (81 vs. 45 pM, p < 0.001) and at two hours after taking glucose (496 vs. 267 pM, p < 0.001).
Levels of high-density lipoprotein (HDL, or ‘bad’) cholesterol were lower in the women with HIV (1.17 vs. 1.34 mM, p < 0.001). Low levels of HDL cholesterol are known to increase the risk of cardiovascular disease. The HIV-positive women also had altered levels of the inflammatory markers, with elevated levels of CRP (4.6 vs. 2.3 mg/l, p = 0.007) and IL-6 (2.7 vs. 1.8 pg/ml, p = 0.02). These are both linked to an increased risk of cardiovascular disease. Although there were differences in the use of hormone replacement therapy and smoking between the two groups of women, read more
