Lipoprotein‐associated phospholipase A2 and cardiovascular disease risk in HIV infection

Objectives HIV‐infected patients on antiretroviral therapy (ART) have an increased cardiovascular disease (CVD) risk as a result of heightened inflammation and immune activation, despite at times having normal lipids and few traditional risk factors. Biomarkers are needed to identify such patients before a clinical event. Lipoprotein‐associated phospholipase A2 (Lp‐PLA2) predicts CVD events in the general population. This study investigated the relationship between Lp‐PLA2 and markers of CVD risk, systemic inflammation, immune activation, and coagulation in HIV infection. Methods One hundred subjects on stable ART with normal fasting low‐density lipoprotein (LDL) cholesterol were enrolled in the study. Plasma Lp‐PLA2 concentrations were measured by enzyme‐linked immunosorbent assay (ELISA; > 200 ng/mL was considered high CVD risk). Subclinical atherosclerosis, endothelial function, inflammation, immune activation and fasting lipids were also evaluated. Results The median age of the patients was 47 years and 77% were male. Median (range) Lp‐PLA2 was 209 (71–402) ng/mL. Fifty‐seven per cent of patients had Lp‐PLA2 concentrations > 200 ng/mL. Lp‐PLA2 was positively correlated with soluble markers of inflammation or immune activation (tumour necrosis factor receptor‐II, intercellular and vascular cellular adhesion molecules, and CD14; all R = 0.3; P