The association of epicardial adipose tissue volume and density with coronary calcium in HIV-positive and HIV-negative patients

Aims: We sought to assess and compare the association of epicardial adipose tissue (EAT) with cardio-vascular disease (CVD) in HIV-positive and HIV-negative groups.Methods and results: Using existing clinical databases, we analyzed 700 patients (195 HIV-positive, 505 HIV -negative). CVD was quantified by the presence of coronary calcification from both dedicated cardiac computed tomography (CT) and non-dedicated CT of the thorax. Epicardial adipose tissue (EAT) was quantified using dedicated software. The HIV-positive group had lower mean age (49.2 versus 57.8, p < 0.005), higher proportion of male sex (75.9 % versus 48.1 %, p < 0.005), and lower rates of coronary calcification (29.2 % versus 58.2 %, p < 0.005). Mean EAT volume was also lower in the HIV-positive group (68mm3 versus 118.3mm3, p < 0.005). Multiple linear regression demonstrated EAT volume was associated with hepatosteatosis (HS) in the HIV-positive group but not the HIV-negative group after adjustment for BMI (p < 0.005 versus p = 0.066). In the multivariate analysis, after adjustment for CVD risk factors, age, sex, statin use, and body mass index (BMI), EAT volume and hepatosteatosis were significantly associated with coronary calcification (odds ratio [OR] 1.14, p < 0.005 and OR 3.17, p < 0.005 respectively). In the HIV -negative group, the only significant association with EAT volume after adjustment was total cholesterol (OR 0.75, p = 0.012).Conclusions: We demonstrated a strong and significant independent association of EAT volume and cor-onary calcium, after adjustment, in HIV-positive group but not in the HIV-negative group. This result hints at differences in the mechanistic drivers of atherosclerosis between HIV-positive and HIV-negative groups.(c) 2023 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study compared the association of cardiovascular disease (CVD) with epicardial adipose tissue (EAT) in HIV-positive and HIV-negative patients. The results showed that, after adjustment, EAT volume was significantly associated with coronary calcification in the HIV-positive group, but not in the HIV-negative group, suggesting differences in the mechanistic drivers of atherosclerosis between these two groups.