The Changes Of Adiponectin And High-sensitivity C-reactive Protein In HIV-infected Patients Receiving Antiretroviral Therapy

The highly active antiretroviral therapy (HAART) has dramatically reduced themortality and morbidity associated with HIV infection, and increased life expectancy.However, long-term side effects such as cardiovascular disease (CVD) constitute a newemerging challenge for physicians involved in the care of HIV-positive patients. It isreported that the incidence of cardiovascular disease (CVD) in HIV-infected population isat least three times higher than in the general population. Moreover, the World HealthOrganization predicts that HIV/AIDS and CVD will be in the top3causes for globalmortality in the year2030. But, the cardiovascular impact has been poorly evaluated andreports in the literature of antiretroviral drugs have been inconsistent and contradictory.Therefore, predicting the CVD in HIV-positive patients has become one of the hottesttopics in public health. According to the present situation, strategies to estimate the association between HIV,antiretroviral therapy (ART) and CVD risk could take a direct or indirect approach. Adirect approach would compare myocardial infarction (MI) rates or carotid intima-mediathickness (C-IMT) within or between large populations. Indirect strategies could estimatethe effect of ART on risk factors and surrogate markers for CVD. For example,adiponectin（APN）and high-sensitivity C-reactive protein（hs-CRP）are two importantsurrogate CVD markers, which have high clinical and scientific research value. Therefore,we have monitored change of APN and hs-CRP of HIV-infected patients in ourretrospective study in order to lay a basis for early estimating CVD of this population.Main methods and contents:1. To observe the change of APN levels in HIV-infection patients with or without HAARTfrom lateral and longitudinal perspectiones, blood was drawn and was immediatelycentrifuged at room temperature after collection. Then, APN levels were measured byin-house enzyme-linked immunosorbent assays (ELISA). These works were laid basis forthe following experiments and analysis.2. To observe the change of hs-CRP levels in HIV-infection patients with or withoutHAART from lateral and longitudinal perspectiones, blood was drawn and wasimmediately centrifuged at room temperature after collection. Then, hs-CRP levels weremeasured by in-house enzyme-linked immunosorbent assays (ELISA). These works werelaid basis for the following experiments and analysis.3. To observe the change of CD4+lymphocyte cell count in HIV-infection patients with orwithout HAART from lateral and longitudinal perspectiones, blood was drawn. Then,CD4+lymphocyte cell count was analyzed by three-color flow cytometry within24hours.These works were laid basis for the following experiments and analysis.Main results:1. We found that APN level was significantly lower in treatment experienced group than intreatment naive group and health blood donor group (3.35±3.21ug/ml, vs.6.34±6.93ug/ml and5.34±5.44ug/ml; P=0.003, P=0.001, respectively). APN levels of36patients intreatment experienced group were evaluated in12,24,36,48and60weeks of HAARTinitiation. We also found that APN levels were significantly lower after48and60weeksHAART therapy (P=0.01, P=0.001, respectively).2. There was no significantly change of hs-CRP levels among the three groups. Hs-CRPlevels of36patients in treatment experienced group were evaluated in12,24,36,48and60weeks of HAART initiation. We also found that there was no significantly change ofhs-CRP levels throughout the study period.3. CD4+lymphocyte cell count levels were significantly higher in treatment experiencedgroup than in treatment naive group (350.2±149.5个/μL vs.234.5±149.5个/μL; P＜0.001). CD4+lymphocyte cell count levels of36patients in treatment experienced groupwere evaluated in12,24,36,48and60weeks of HAART initiation. We found that CD4+lymphocyte cell count levels were significantly higher after12weeks HAART therapy (P＜0.05).4. Compared with treatment na ve patients, there were significantly increases levels oftotal cholesterol (TC) after12weeks, triglyceride (TG) after48weeks and low-densitylipoprotein (LDL) after24weeks.Conclusions:In HIV-infected patients receiving antiretroviral therapy, we found that APN levelswere increased at first and then were gradually reduced, and TC、TG and LDL weregradually increased, however, there were no significantly changes of hs-CRP levelsthroughout the study period. Because hypoadiponectinemia and dyslipidemia were CVDrisk factors, dynamic monitoring the changes of these marks may be beneficial to the earlyprevention of CVD.