Biomarkers and HIV-associated cardiovascular disease

Purpose of review Our goal is to summarize recent literature on biomarkers of cardiovascular disease (CVD) in the setting of HIV infection with an emphasis on those associated with clinical events. Recent findings Epidemiological data have demonstrated that HIV infection is associated with increases in well established markers of inflammation and thrombosis, and levels of high sensitivity C-reactive protein, interleukin-6, and D-dimer predict CVD and mortality risk in HIV cohorts. Levels of interleukin-6, D-dimer and endothelial adhesion molecules increase when antiretroviral therapy is interrupted, suggesting that HIV replication may be driving CVD risk in this context. However, data on changes in many CVD biomarkers after starting antiretroviral therapy are inconsistent or lacking. Finally, high-density lipoprotein particles may be more informative than other lipoprotein measures for CVD risk specifically among individuals with HIV infection. Summary Biomarkers of inflammation and thrombosis have the potential to improve CVD risk stratification beyond traditional and HIV-specific factors, and may prove useful for evaluating CVD prevention strategies for individuals with HIV infection.