Higher Levels of Osteoprotegerin and Immune Activation/Immunosenescence Markers Are Correlated with Concomitant Bone and Endovascular Damage in HIV-Suppressed Patients

Alessandra D’Abramo

HIV+ patients have an increased risk of non-AIDS comorbidities such as osteoporosis and atherosclerosis. Subjects with osteoporosis are at a higher risk of developing cardiovascular disease (CVD) than those with normal bone mass. During HIV infection, several factors might contribute to bone disease and endothelial dysfunction. The aim of the study was to evaluate the relationship between bone and CVD and to investigate the role of, T-cell phenotype and osteoprotegerin (OPG) in HIV+ subjects on effective antiretroviral therapy (ART). We included 94 HIV+ subjects on effective ART and 41 healthy subjects as a control group. Carotid-Intima Media Thickness (c-IMT) and bone mineral density (BMD) were performed by ultrasound and DEXA, respectively. CD4+/CD8+ T-cell activation, senescence and OPG plasma levels were measured by flow-cytometry and ELISA, respectively. Among HIV+ patients, subjects with pathological c-IMT and low BMD had higher CD4+ and CD8+ activated, CD8+ senescent and OPG than subjects with normal c-IMT and BMD. HIV+ subjects with low BMD had higher c-IMT than subjects with normal BMD and linear regression analysis showed a negative correlation between BMD and c-IMT. Several factors are implicated in the pathogenesis of non-AIDS comorbidities in HIV+ patients. OPG together with inflammation and immunesenescence in HIV+ patients could affect bone and vascular system and could be considered as a possible common link between these two diseases.

Simone Agnello
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