CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 3, May/June 2011
136
AFRICA
matory and cell adhesion biomarkers of the infected and unin-
fected groups while adjusting for mean arterial pressure (MAP),
tobacco and alcohol use.
Partial correlations were performed in the HIV-uninfected,
-infected and nadir CD
4
cell count groups while adjusting for
MAP, tobacco and alcohol use. For the cr-PWV analysis, the
subjects were divided into three age groups (with 10-year inter-
vals; group 1
≤
40 years, group 2
=
40–50 years and group 3
≥
50
years) and ANCOVA (adjusted for gender, BMI, MAP, tobacco
and alcohol use) was performed. The cr-PWV was plotted for the
HIV-infected and -uninfected participants.
Results
The characteristics of the HIV-infected participants and match-
ing controls as well as the subgroup of the HIV-infected partici-
pants with a nadir CD
4
cell count
<
200 cells/mm
3
are reported
in Table 1. Due to individual matching, age and BMI values were
identical in the HIV-infected and uninfected (control) groups.
The SBP and HDL-C values were lower and the TG levels,
TG:HDL-C ratio, and hsIL-6, hsCRP, sICAM-1 and sVCAM-1
concentrations were higher in the HIV-infected compared to the
uninfected participants. The lowest HDL-C levels were seen in
the HIV-infected participants with a nadir CD
4
cell count.
Although the mean levels of hsIL-6, hsCRP, sICAM-1 and
sVCAM-1 were the highest in the nadir CD
4
cell count group,
only sVCAM-1 levels differed statistically significantly when
compared with the uninfected group. When the low HDL-C
and high hsIL-6, hsCRP, sICAM-1 and sVCAM-1 values of the
nadir CD
4
cell count group were compared to the infected partici-
pants with a CD
4
cell count
>
200 cells/mm
3
, again only the
sVCAM-1 values differed significantly (
p
=
0.046). After adjust-
ments for MAP, alcohol and tobacco use, the overall results did
not change. No gender differences were seen.
The odds ratios of the HIV-infected group versus the uninfect-
ed group are shown in Table 2. In this study population, having a
lower HDL-C level was 3.7 times more likely in the HIV-infected
participants. The odds ratio for having higher hsCRP and TG
levels, TG:HDL ratio, and hs-IL-6, sICAM-1 and sVCAM-1
levels was respectively, 1.8, 1.7, 3.3, 1.7, 2.0 and 3.9 times more
in the HIV-infected participants.
Partial correlations (adjusted for MAP, tobacco and alcohol
use) with a
p
-value
<
0.05 are listed in Table 3. HDL-C values
correlated inversely with TG levels in all three groups (
r
=
–0.23,
p
< 0.001;
r
=
–0.16,
p
=
0.005;
r
=
–0.55,
p
=
0.41), with
log sICAM-1 levels in the uninfected (
r
=
–0.14,
p
=
0.02) and
infected groups (
r
=
–0.15,
p
= 0.009), and with hsIL-6 levels
only in the HIV-infected group (
r
=
–0.21,
p
=
0.001). In the
TABLE 1. CHARACTERISTICS OF PARTICIPANTS: HIV UNINFECTED, HIV INFECTED,
AND HIV INFECTEDWITHA NADIR CD
4
CELL COUNT
<
200 CELLS/MM
3
HIV uninfected
(
n
=
300)
p
-value
†
HIV
uninfected/
infected
HIV infected
(
n
=
300)
p
-value
†
HIV
uninfected/nadir
CD
4
cell count
Nadir CD
4
cell
count (
n
=
18)
p
-value
‡
trend
Age (years)
44.0
±
7.81
0.971
44.0
±
8.04
0.679
44.8
±
8.48
0.904
Men/women (
n
)
116/184
1.000
116/184
0.135
10/8
0.316
Body mass index (kg/m
2
)
22.8
±
5.48
0.916
22.9
±
5.59
0.122
20.8
±
3.96
0.258
Systolic blood pressure (mmHg)
129
±
21.8
0.003
124
±
21.8
0.309
124
±
17.5
0.015
Diastolic blood pressure (mmHg)
85.9
±
14.3
0.099
84.0
±
14.7
0.145
80.9
±
10.6
0.191
Mean arterial pressure (mmHg)
100
±
16.1
0.024
97.5
±
16.7
0.179
95.3
±
12.1
0.179
Carotid radialis pulse wave velocity (m/s)
10.9
±
2.30
0.606
11.1
±
2.10
0.307
11.5
±
2.30
0.561
Lipids:
HDL-C (mmol/l)
1.70
±
0.71
<
0.001
1.23
±
0.58
<
0.001
1.07
±
0.47
<
0.001
TG (mmol/l)
1.15
±
0.75
0.031
1.29
±
0.77
0.814
1.19
±
0.76
0.085
TG:HDL-C ratio
0.86
±
1.21
<
0.001
1.41
±
1.47
0.006
1.19
±
0.21
<
0.001
Inflammatory markers:
hsIL-6 (pg/ml)
3.72 (1.11–16.9)
<
0.001
4.70 (1.29–20.9)
0.124
5.03 (1.10–22.3) 0.002
hsCRP (mg/l)
2.13 (0.23–29.2)
<
0.001
3.31 (0.32–50.4)
0.012
5.34 (0.56–62.1) 0.001
sICAM-1 (ng/ml)
405 (111–1345)
<
0.001
577 (192–1610)
0.009
696 (194–1884)
<
0.001
sVCAM-1 (ng/ml)
397 (19–2252)
<
0.001
847 (101–3230)
0.001
1262 (143–3421)
<
0.001
Coagulation markers:
Fibrinogen (g/l)
2.99 (1.39–7.19)
0.041
2.75 (1.29–6.99)
0.785
3.11 (1.39–9.00) 0.073
PAI-1 (IU/ml)
1.39 (0.01–17.3)
0.681
1.52 (0.01–18.8)
0.433
0.83 (0.01–17.4) 0.563
Glucose (mmol/l)
5.50
±
1.10
0.126
5.35 ± 1.26
0.052
4.97 ± 0.29
0.122
eCrCl (ml/min)
79.7 (16.1–157)
0.150
73.5 (15.1–160)
0.790
76.5 (9.58–163)
0.345
Tobacco users,
n
(%)
137 (45.6)
0.410
127 (42.3)
0.082
12 (66.7)
0.071
Alcohol users,
n
(%)
103 (34.3)
0.543
96 (32.0)
0.693
7 (38.9)
0.678
n
: number of participants; HDL-C: high-density lipoprotein cholesterol; TG: triglycerides; hsIL-6: high-sensitivity interleukin 6; hsCRP: high-
sensitivity C-reactive protein; sICAM-1: serum intercellular adhesion molecule-1; sVCAM-1: serum vascular cell adhesion molecule-1; PAI-1:
plasminogen activator inhibitor-1.
Data are expressed as arithmetic mean
±
standard deviation, geometric mean (5th and 95th percentile intervals) or % of
n
.
†
p
-values between uninfected/infected and uninfected/nadir CD
4
cell count were obtained with independent
t
-test.
‡
p
-values trend was obtained with ANOVA, and for gender, tobacco and alcohol users, Chi-square test was used.
