Homocysteine modifies the association of coronary stenosis and HIV infection in an inner city African American population

Authors

Thorsten M. Leucker, Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Tarek Harb, Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Gary Gerstenblith, Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
David D. Celentano, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Efthymios Ziogos, Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Glenn Treisman, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Raul N. Mandler, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
Jag Khalsa, Department of Microbiology, Immunology and Tropical Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Man Charurat, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
Shenghan Lai, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Hong Lai, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.

Document Type

Journal Article

Publication Date

3-26-2024

Journal

International journal of STD & AIDS

DOI

10.1177/09564624241242171

Keywords

Coronary stenosis; HIV infection; Homocysteine

Abstract

BACKGROUND AND AIMS: People with HIV (PWH) whose disease is controlled on anti-retroviral regimens remain at an increased risk for coronary artery disease (CAD). Traditional cardiovascular risk factors do not fully explain the residual risk in PWH suggesting contributions from nontraditional factors. Homocysteine (Hcy) may be one of these as prior work in adults without HIV demonstrate that Hcy may impair endothelial function by decreasing the availability of nitric oxide, promoting the development of atherosclerosis. In addition, plasma Hcy levels are higher in PWH than in individuals living without HIV. The aim of this study was to investigate whether Hcy levels influence the association between HIV and coronary stenosis in an inner city African American population. METHODS: African Americans from the Heart Study in Baltimore, with and without HIV, recruited from inner-city Baltimore between June 2004 and February 2015, were included in this analysis. Participants underwent coronary CT angiography to evaluate the presence of coronary stenosis, defined as luminal stenosis >10%. Hcy was measured from stored serum samples. RESULTS: In this analysis, the median [IQR] age of the 664 participants was 56 [50-66] years; 68.1% were living with HIV and 43.1% were women. Elevated Hcy (>15 µmol/L) was more prevalent in those with coronary stenosis (23.3%, 95% CI: 18.4%-28.2%) than in those without coronary stenosis (13.1%, 95% CI: 9.7%-16.5%) ( = 0.0007), and HIV was associated with coronary stenosis in those participants with an elevated Hcy (Prevalence Ratio: 1.94, 95% CI: 1.04-3.64, = 0.0038) and not in those with a Hcy ≤15 µmol/L (Prevalence Ratio: 1.02, 95% CI: 0.83-1.25, = 0.87). CONCLUSIONS: Our data suggest an association between elevated Hcy levels (>15 µmol/L) and the prevalence of coronary stenosis in PWH from this inner city African American population.

APA Citation

Leucker, Thorsten M.; Harb, Tarek; Gerstenblith, Gary; Celentano, David D.; Ziogos, Efthymios; Treisman, Glenn; Mandler, Raul N.; Khalsa, Jag; Charurat, Man; Lai, Shenghan; and Lai, Hong, "Homocysteine modifies the association of coronary stenosis and HIV infection in an inner city African American population" (2024). GW Authored Works. Paper 4477.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4477

Department

Microbiology, Immunology, and Tropical Medicine