Background: Patients infected with the human immunodeficiency virus (HIV) have an increased risk of cardiovascular
disease due to increased inflammation and persistent immune activation. CD163 is a macrophage scavenger receptor that is
involved in monocyte-macrophage activation in HIV-infected patients. CD163 interacts with TWEAK, a member of the TNF
superfamily. Circulating levels of sTWEAK and sCD163 have been previously associated with cardiovascular disease, but no
previous studies have fully analyzed their association with HIV.
Objective: The aim of this study was to analyze circulating levels of sTWEAK and sCD163 as well as other known markers of
inflammation (hsCRP, IL-6 and sTNFRII) and endothelial dysfunction (sVCAM-1 and ADMA) in 26 patients with HIV before and
after 48 weeks of antiretroviral treatment (ART) and 23 healthy subjects.
Results: Patients with HIV had reduced sTWEAK levels and increased sCD163, sVCAM-1, ADMA, hsCRP, IL-6 and sTNFRII
plasma concentrations, as well as increased sCD163/sTWEAK ratio, compared with healthy subjects. Antiretroviral treatment
significantly reduced the concentrations of sCD163, sVCAM-1, hsCRP and sTNFRII, although they remained elevated when
compared with healthy subjects. Antiretroviral treatment had no effect on the concentrations of ADMA and sTWEAK,
biomarkers associated with endothelial function. The use of protease inhibitors as part of antiretroviral therapy and the
presence of HCV-HIV co-infection and/or active HIV replication attenuated the ART-mediated decrease in sCD163 plasma
concentrations.
Conclusion: HIV-infected patients showed a proatherogenic profile characterized by increased inflammatory, immuneactivation and endothelial-dysfunction biomarkers that partially improved after ART. HCV-HIV co-infection and/or active HIV
replication enhanced immune activation despite ART.Redes Temáticas de Investigación en SIDA (ISCIII RETIC RD12/0017/0029 and RD12/0017/0037)Junta de Andalucía, Incentivos a proyectos de investigación de excelencia (CTS-6313, to Manolo Leal)Consejería de Salud (PI-0278)FIS PI10/00234 to LMBC and Programa Miguel Servet: CP10/00479 and PI13/00802 to JAMFundacion Lilly, FRIAT and ISCIII fund PI10/0007
