{"DOI":"10.1093/ofid/ofab109","PMCID":"PMC8232386","PMID":"34189152","abstract":"Abstract\n \n Background\n Despite antiretroviral therapy (ART), people living with HIV (PLWH) have increased risk of inflammatory comorbidities, including cardiovascular diseases. Gut epithelial damage, and translocation of bacterial lipopolysaccharide (LPS) or fungal \u03b2-D-Glucan (BDG) drive inflammation in ART-treated PLWH. Herein, we investigated whether markers of gut damage and microbial translocation were associated with cardiovascular risk in asymptomatic ART-treated PLWH.\n \n \n Methods\n We cross-sectionally analyzed plasma from 93 ART-treated PLWH and 52 uninfected controls older than 40 years of age from the Canadian HIV and Aging Cohort. Participants were cardiovascular disease free and underwent a cardiac computed tomography to measure total coronary atherosclerotic plaque volume (TPV). Levels of bacterial LPS, and gut damage markers REG3\u03b1 and I-FABP were measured by ELISA. Fungal BDG levels were analyzed using the Fungitell \u00ae assay.\n \n \n Results\n BDG levels but not LPS were significantly elevated in ART-treated PLWH with coronary artery plaque (p=0.0007). Moreover, BDG but not LPS levels correlated with TPV (r=0.25, p=0.01). I-FABP but not REG3\u03b1 levels correlated with TPV (r=0.23, p=0.03). However, BDG and LPS levels were not elevated in uninfected controls with plaque. In multivariable models, elevated BDG levels were independently associated with the presence of coronary atherosclerosis in PLWH but not in uninfected controls.\n \n \n Conclusion\n Translocation of fungal BDG was associated with coronary atherosclerosis assessed by CT-scan imaging in ART-treated PLWH, suggesting a HIV-specific pathway leading to cardiovascular disease. Further investigation is needed to appraise causality of this association. Translocation of fungal products may represent a therapeutic target to prevent cardiovascular disease in ART-treated PLWH.\n ","author":[{"family":"Isnard","given":"St\u00e9phane"},{"family":"Fombuena","given":"Brandon"},{"family":"Sadouni","given":"Manel"},{"family":"Lin","given":"John"},{"family":"Richard","given":"Corentin"},{"family":"Routy","given":"Bertrand"},{"family":"Ouyang","given":"Jing"},{"family":"Ramendra","given":"Rayoun"},{"family":"Peng","given":"Xiaorong"},{"family":"Zhang","given":"Yonglong"},{"family":"Finkelman","given":"Malcolm"},{"family":"Tremblay-Sher","given":"Daniel"},{"family":"Tremblay","given":"Cecile"},{"family":"Chartrand-Lefebvre","given":"Carl"},{"family":"Durand","given":"Madeleine"},{"family":"Routy","given":"Jean-Pierre"},{"family":"Cohort"}],"id":"unknown","issue":"6","issued":{"date-parts":[[2021,3,6]]},"language":"en","page-first":"ofab109","publisher":"Oxford University Press (OUP)","title":"Circulating \u03b2-D-Glucan as a marker of subclinical coronary plaque in ART-treated people living with HIV","type":"article-journal","volume":"8"}