Endothelial adhesion molecules are associated with inflammation in subjects with HIV disease

Background. The presence of the adhesion molecules intercellular adhesion molecule-1 (ICAM-1) and soluble vascular cell adhesion molecule-1 (VCAM-1) is associated with elevated risk of cardiovascular disease. Subjects with human immunodeficiency virus (HIV) disease have multiple risk factors for cardiovascular disease, including elevated serum lipid levels, insulin resistance, and elevated levels of ICAM-1 and VCAM-1. This study assessed the variables associated with elevated adhesion molecule levels in this patient population. Methods. Serum levels of ICAM-1 and VCAM-1 were assessed in 31 subjects without HIV disease and 52 subjects with HIV disease. Pearson correlation indicated a significant relationship between ICAM concentration and other variables, including CD4(+) cell count, HIV viral burden, insulin sensitivity, and serum lipid level. Multiple regression modeling was used to determine the strengths of association among the variables. Results. Subjects with HIV disease had elevated levels of ICAM-1 and VCAM-1. Pearson correlation analysis revealed significant associations between ICAM-1 and VCAM-1 level and insulin sensitivity, plasma lipid level, and presence of type 2 soluble receptor for tumor necrosis factor-alpha (sTNFR2). With multiple regression modeling to control for interdependence, only sTNFR2, a marker of inflammation, was an independent predictor of ICAM-1 and VCAM-1 levels. Conclusions. The study suggests that many of the variables associated with ICAM-1 and VCAM-1 levels can be related to their impact on inflammation.