Identifying risk factors for subclinical myocardial disease in HIV infection

Project: Research project

Project Details

Description

Aim: To determine if HIV-infected, compared to HIV-uninfected individuals, have greater myocardial disease burden after controlling for age, sex, nicotine use, and traditional CVD risk factors. Hypothesis: HIV infection and/or factors related to HIV infection are independently associated with greater myocardial disease burden, even among persons who are virally suppressed and receiving HAART. We will examine the role of specific factors in the Subaims.
a. To determine if substance use and related factors are associated with myocardial disease burden in HIV+ individuals and if greater substance use contributes to the association between HIV infection and myocardial disease burden. Hypothesis: Substance abuse, particularly use of cardiotoxic drugs, are independently associated in a dose-dependent fashion with greater myocardial disease in HIV+ individuals compared to HIV- individuals.
i. Are the types of substances abused, route of administration, proximal time period of abuse, intensity and/or periodicity of use associated with greater myocardial disease burden in HIV-infected individuals?
ii. Is myocardial disease burden higher among HIV-infected individuals who abused cardiotoxic substances compared to other groups?
b. Are factors associated with more advanced HIV clinical disease HIV specific factors [e.g. lower nadir CD4+ T cell count (CD4), higher plasma HIV RNA load, shorter duration of HAART use] associated with increased myocardial disease among HIV+ individuals independent of substance use? Hypothesis: More advanced stages of HIV disease and/or suboptimal HIV disease control are independently associated with greater myocardial disease.
c. Are higher systemic levels of inflammatory biomarkers associated with greater myocardial disease in HIV+ individuals? Hypothesis: HIV-induced immune activation independently increases myocardial disease burden.
d. Is greater CAD burden associated with increased myocardial disease in HIV+ compared to HIV- individuals in MACS? Hypothesis: Increased CAD and its downstream effects on the myocardium (ischemia and fibrosis) are associated with myocardial abnormalities and partially explain increased prevalence of myocardial abnormalities in HIV+ individuals.
StatusFinished
Effective start/end date9/15/147/31/18

Funding

  • Johns Hopkins University (2002507820//5R01HL126552-04)
  • National Heart, Lung, and Blood Institute (2002507820//5R01HL126552-04)

Fingerprint

Explore the research topics touched on by this project. These labels are generated based on the underlying awards/grants. Together they form a unique fingerprint.