Inflammation, Viral Replication, and Atherosclerosis in Treated HIV Infection
This is a longitudinal observational study of HIV-infected patients and HIV-negative control patients that is being conducted to learn more about immunologic factors, inflammation, and cardiovascular risk in patients with HIV infection or in patients with autoimmune disease. The investigators plan to obtain measurement of carotid artery intima media thickness (IMT) using high resolution ultrasound as a noninvasive means for tracking atherosclerotic progression. The investigators will also measure lipid and lipoprotein levels, inflammatory markers, markers of Cytomegalovirus (CMV) infection, thrombotic markers, atherogenic lipoproteins, and markers of immune function. Immunophenotyping will be performed on freshly collected blood and analyzed by flow cytometry to identify activated T-cells, T-cell turnover, proportions of T-cells, and CMV function. HIV-infected patients will have CD4 count and HIV viral load measured in addition. Patients will undergo detailed clinical history including HIV disease, specific HIV medications, comorbid conditions, and health related behaviors. Physical exam and measurements will be obtained to assess for the presence of lipodystrophy. Patients will undergo study visits for ultrasound, blood draw, and interview at 4-12 month intervals for the next 3 years.
Patients will also go assessment of endothelial function, endothelial progenitor cells, arterial stiffness as measured using pulse wave tonometry.
To demonstrate the feasibility of a larger scale investigation of cardiac arrhythmia in HIV positive and negative patients with cardiac disease, the investigators will use 48-hour Holter monitor surveillance to monitor HIV-infected and uninfected patients with a history of myocardial infarction, systolic left ventricular dysfunction, and/or pulmonary artery hypertension for the presence of cardiac arrhythmia.
The FDG PET scan (18F-fluorodeoxyglucose positron emission tomography-computed tomography) will be used to detect and quantify inflammation in the body.
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Immunologic and Inflammatory Factors and Cardiovascular Risk in Patients With HIV Infection or Autoimmune Diseases|
- carotid intima-media thickness [ Time Frame: 2 years ]Increased carotid intima-media thickness (mm)
- brachial artery flow-mediated dilatation [ Time Frame: 2 years ]decreased brachial artery flow-mediated dilatation (%)
- D-dimer [ Time Frame: 2 years ]Increased D-dimer levels (mcg/mL)
|Study Start Date:||July 2003|
|Estimated Study Completion Date:||June 2020|
|Estimated Primary Completion Date:||June 2019 (Final data collection date for primary outcome measure)|
HIV-infected patients who are on a stable antiretroviral drug regimen for at least a year; all plasma HIV RNA levels within the past year must be below conventional levels of detection (< 50 copies RNA/mL).
Please refer to this study by its ClinicalTrials.gov identifier: NCT01519141
|United States, California|
|University of California San Francisco, San Francisco General Hospital|
|San Francisco, California, United States, 94110|
|Principal Investigator:||Priscilla Hsue, MD||University of California, San Francisco|