Higher epicardial fat in older adults living with HIV with viral suppression and relationship with liver steatosis, coronary calcium and cardiometabolic risks

Abstract

Anchalee Avihingsanon b,h , the HIV-NAT 006/207 study team Objectives: HIV infection is associated with ectopic fat deposition, which leads to chronic inflammation and cardiometabolic dysregulation. We assessed the epicardial adipose tissue (EAT) volume and its associated factors among people with HIV (PWH).Design: A cross-sectional study.Methods: We conducted a cross-sectional study among PWH aged at least 50 years and age-matched and sex-matched HIV-negative older individuals in Bangkok, Thailand. Participants underwent a noncontrast, cardiac computed tomography (CT) scan to assess coronary artery calcium (CAC) score and EAT between March 2016 and June 2017. Multivariate linear regression analyses were used to investigate HIV-related factors, cardiac and metabolic markers associated with EAT volume.Results: Median age was 55 years [interquartile range (IQR) 52-60] and 63% were men. Median duration of antiretroviral therapy (ART) was 16 years with 97% had HIV-1 RNA less than 50 copies/ml and median CD4 þ cell count of 617 cells/ml. Median EAT volume was significantly higher in cm 3 ] than HIV-negative individuals [93 (IQR 69-117) cm 3 ], P ¼ 0.022. In adjusted model, factors associated with EAT volume included male sex (P ¼ 0.045), older age (P < 0.001), abnormal waist circumference (P < 0.001) and HOMA-IR (P ¼ 0.01). In addition, higher CAC score was independently associated with EAT volume. Higher mean EAT volume was seen in PWH with severe liver steatosis than those without steatosis (P ¼ 0.018). In adjusted PWH-only model, duration of HIV was significantly associated with higher EAT volume (P ¼ 0.028). Conclusion:In an aging cohort, PWH had higher EAT volume than HIV-negative controls. EAT was also independently associated with central fat accumulation, insulin resistance, liver steatosis and CAC score.

Metabolic‐Associated Fatty Liver Disease (MAFLD) is associated with immune activation, increased epicardial fat volume, and steatohepatitis among people with HIV in a Thai cohort

“…All participants also underwent a non‐contrast cardiac computed tomography (CT) scan using Dual‐Source CT scanner (SOMATOM Force; Siemens, Germany) to evaluate the coronary artery calcium (CAC) score and epicardial fat volume. Epicardial fat evaluation procedures in this study have been described previously [13]. The Agatston method was used to quantify the CAC score, which was categorized into four groups: 0, 1–100, 101–400, and >400.…”

“…All people living with HIV were aged >50 years at the time of recruitment. The eligibility criteria for the aging cohort have been previously published [13][14][15]. At the time of enrolment, we excluded participants with known CVDs, including myocardial infarction, ischemia, angina pectoris, and stroke, and those who had previously undergone coronary procedures, such as coronary angioplasty and coronary artery surgery.…”

Association of Phenotypic Aging Marker with comorbidities, frailty and inflammatory markers in people living with HIV

“…This is a cross-sectional study among PLWH recruited for an aging study cohort at the HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre in Bangkok, Thailand during 2016 and 2018. The characteristics of the aging cohort were described previously [ 18 , 19 ]. Briefly, people with abnormal fat distribution, such as Cushing syndrome, hypercortisolism and those who were on steroids were excluded.…”

Higher prevalence of QTc interval prolongation among virologically suppressed older people with HIV

“…People with HIV (PWH) are living longer with a higher rate of cardiovascular comorbidities including high subclinical cardiovascular disease among PWH in Thailand [1,2]. One such condition is QTc interval prolongation which occurs in PWH with prevalence ranging from 10% to 16%, versus 7% to 9% in HIVnegative populations [3][4][5][6][7].…”