C-reactive protein as a predictor of cardiovascular risk in HIV-infected individuals
Clare L. V. Westhorpe A J , Hans G. Schneider B C , Mandy Dunne A , Tracey Middleton D , Vijaya Sundararajan E J , Tim Spelman A , Vanessa Carter F , Suzanne M. Crowe A G , Anthony Dart H , Anne Mijch C G , Despina Kotsanas I and Ian Woolley C G I J KA Macfarlane Burnet Institute for Medical Research and Public Health, Prahran, Vic. 3004, Australia.
B Alfred Pathology Service, Alfred Health, Commercial Road, Prahran, Vic. 3004, Australia.
C Department of Medicine, Central and Eastern Clinical School, Monash University, Melbourne, Vic. 3004, Australia.
D Victorian Infectious Diseases Reference Laboratory, Wreckyn Street, North Melbourne, Vic. 3051, Australia.
E Department of Human Services Victoria, Lonsdale Street, Melbourne, Vic. 3000, Australia.
F Department of Nutrition, The Alfred Hospital, Commercial Road, Prahran, Vic. 3004, Australia.
G Department of Infectious Diseases, The Alfred Hospital, Commercial Road, Prahran, Vic. 3004, Australia.
H Department of Cardiology, The Alfred Hospital, Commercial Road, Prahran, Vic. 3004, Australia.
I Department of Infectious Diseases, Monash Health, Clayton Road, Clayton, Vic. 3168, Australia.
J Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton Road, Clayton, Vic. 3168, Australia.
K Corresponding author. Email: ian.woolley@monash.edu
Sexual Health 11(6) 580-582 https://doi.org/10.1071/SH14130
Submitted: 6 July 2014 Accepted: 3 October 2014 Published: 1 December 2014
Abstract
Background: In some studies HIV infection confers approximately two-fold higher risk of cardiac events compared with the general population. C-reactive protein (CRP) is a well-characterised biomarker of cardiac events in the general population and is also elevated in patients with HIV infection. The aim of this study was to determine the predictive value of CRP for cardiac events in HIV-infected individuals. Methods: We retrospectively analysed CRP levels in stored plasma samples from HIV-infected patients who did or did not experience a coronary event in a case-controlled manner. All CRP measurements were performed using a high-sensitivity assay (hs-CRP). Results: Of the study participants with samples available, we found slightly elevated hs-CRP levels in the cardiac cases (median 3.5, IQR 1.6–14.4, n = 23) compared with controls (median 2.6, IQR1.2–8.3, n = 49) which were shown to not be statistically significant P = 0.20. Analysis of CRP as a binary variable (≥5 mg L–1) was also not statistically significant (OR: 1.32, 95% CI 0.48–3.63). Conclusions: CRP levels may indicate elevated risk of future cardiac events, however this must be interpreted with caution due to the generalised elevation of CRP during HIV infection. CRP has no predictive value for atherosclerosis, and further research is required to improve early prediction of cardiovascular disease in HIV infection.
Additional keywords: atherosclerosis, hsCRP, inflammation.
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