147 - Levels of anti-apolipoprotein A1 autoantibodies are associated with inflammatory response and metabolomic changes in HIV patients (ID 454)
Abstract
Background and Aims
Autoantibodies against apolipoprotein A1 (anti-apoA1 IgG) are associated with cardiovascular risk. The aim of the study was to evaluate the association between anti-apoA1 IgG levels and indices of viral suppression, clinical parameters, inflammatory biomarkers and circulating metabolites known to underlie atherosclerosis burden, in HIV-free and antiretroviral therapy (ART) experienced and naïve HIV-infected patients.
Methods
Anti-apoA1 IgG levels were assessed by a homemade ELISA assay in 144 participants from a South African cohort divided in three groups: HIV-free (n=50), HIV-infected/ART experienced (n=50) and HIV-infected/ART naïve (n=44). Inflammatory biomarkers were measured with the Meso Scale Discovery® platform. Targeted metabolomics analyses were performed using standard operating procedure.
Results
The prevalence of anti-apoA1 IgG in HIV-free patients was 24% compared to 40% and 70% in HIV-infected/ART experienced and naïve groups, respectively. In HIV-infected patients, the levels of anti-apoA1 IgG were associated with a significant decrease in CD4+ counts (r=-0.483, p<0.0001) and significant increases in viremia (r=0.379, p=0.002), BMI (r=-0-337, p=0.0009), pro-inflammatory biomarkers (IFNɣ, IL-10, TNFα, MIPα; all r>0.299 and p<0.05), and circulating levels of intercellular and vascular adhesion molecule (ICAM-1, r=0.342, p=0.007 and VCAM-1, r=0.429, p<0.0001). Metabolomics analyses highlighted significant changes in kynurenine metabolism (kynurenine, p=0.0004 and hydroxyl-kynurenine p=0.038) in anti-apoA1 IgG positive patients, which also positively correlated with IFNγ and negatively with HDL levels.
Conclusions
In HIV patients, anti-apoA1 IgG levels were associated with low CD4+ counts, levels of adhesion molecules, pro-inflammatory responses as well as kynurenine pathway, all known features related with increased cardiovascular events.
