Mihăilescu Raluca 1, Aramă Victoria 1, 2, Tilişcan C. 1, 2, Streinu-Cercel A. 1, 2, Ion Daniela 2, Aramă S.Ş 2
1 National Institute of Infectious Diseases ‘Prof. Dr. Matei Bals’, Bucharest, Romania,
2 University of Medicine and Pharmacy ‘Carol Davila’, Bucharest, Romania
Abstract
Background. Under combined antiretroviral therapy, HIV infection has become a chronic condition, still accompanied by a proinflammatory status with a consequent impact on multiple organs. We evaluated the levels of inflammatory biomarkers in HIV-infected patients undergoing specific therapy and their association with the presence of metabolic syndrome. Methods. A non-interventional study was conducted on HIV infected patients undergoing antiretroviral therapy in a tertiary care hospital in 2008. Besides routine laboratory assays, TNF alpha, IL 6 and MCP 1 were tested, by means of BioSource EASIA (Enzyme Amplified Sensitivity Immunoassay). Metabolic syndrome was defined according to International Diabetes Federation. Results. A total of 106 patients were included, with a M:F ratio =1.4; median age of 31 years, mode age of 20 years; mean CD4 cell count of 530/mmc; undetectable HIV viremia found in 69% of the subjects. In detectable versus undetectable HIV viremia samples, a pathological level of biomarkers was found in the following proportion: 53.1 % versus 39.1% for TNF alpha, 16.1% versus 13.2% for IL 6, and 9.7% versus 4.3% for MCP 1 respectively. Metabolic syndrome was identified in 10% of the cases (15.2% versus 8.2% in detectable versus undetectable HIV viremia samples). In multivariate analysis, patients with pathological values of MCP 1 are 11.7 times more likely to develop metabolic syndrome than those with normal values (CI 95% 2-71, p=0.008). Conclusions. In our young study population, MCP 1 is significantly associated with the presence of metabolic syndrome. Identifying key subclinical changes would help to anticipate the developing of metabolic syndrome in HIV infected patients. Once the practical utility of these biomarkers is well understood, it might also call for adequate therapy in order to reduce the incidence of polypathology associated with HIV infection.