Subclinical cardiovascular disease in HIV controller and long-term nonprogressor populations

Research output: Contribution to journalArticle


  • R. M. Brusca
  • D. B. Hanna
  • N. I. Wada
  • J. N. Blankson
  • M. D. Witt
  • L. P. Jacobson
  • L. Kingsley
  • F. J. Palella
  • M. Budoff
  • T. T. Brown
  • K. Anastos
  • J. M. Lazar
  • W. J. Mack
  • P. Bacchetti
  • P. C. Tien
  • Y. Golzar
  • M. Plankey
  • E. Golub
  • R. C. Kaplan
  • W. S. Post

External Institution(s)

  • Johns Hopkins University
  • University of California at Los Angeles
  • University of Pittsburgh
  • Northwestern University
  • Yeshiva University
  • SUNY Downstate Health Sciences University
  • University of Southern California
  • University of California at San Francisco
  • San Francisco VA Health Care System
  • Cook County Health and Hospital System
  • Georgetown University
  • Fred Hutchinson Cancer Research Center


Original languageEnglish (US)
Pages (from-to)217-227
Number of pages11
JournalHIV Medicine
Issue number4
StatusPublished - Apr 1 2020


Objectives: Elite controllers (ECs), viraemic controllers (VCs), and long-term nonprogressors (LTNPs) control HIV viral replication or maintain CD4 T-cell counts without antiretroviral therapy, but may have increased cardiovascular disease (CVD) risk compared to HIV-uninfected persons. We evaluated subclinical carotid and coronary atherosclerosis and inflammatory biomarker levels among HIV controllers, LTNPs and noncontrollers and HIV-uninfected individuals in the Multicenter AIDS Cohort Study (MACS) and the Women’s Interagency HIV Study (WIHS). Methods: We measured carotid plaque presence and common carotid artery intima-media thickness (IMT) in 1729 women and 1308 men, and the presence of coronary artery calcium and plaque in a subgroup of men. Associations between HIV control category and carotid and coronary plaque prevalences were assessed by multivariable regression analyses adjusting for demographics and CVD risk factors. Serum inflammatory biomarker concentrations [soluble CD163 (sCD163), soluble CD14 (sCD14), galectin-3 (Gal-3), galectin-3 binding protein (Gal-3BP) and interleukin (IL)-6] were measured and associations with HIV control category assessed. Results: We included 135 HIV controllers (30 ECs) and 135 LTNPs in the study. Carotid plaque prevalence and carotid IMT were similar in HIV controllers, LTNPs and HIV-uninfected individuals. HIV controllers and LTNPs had lower prevalences of carotid plaque compared to viraemic HIV-infected individuals. The prevalence of coronary atherosclerosis was similar in HIV controllers/LTNPs compared to HIV-uninfected and viraemic HIV-infected men. Controllers and LTNPs had higher concentrations of sCD163 and sCD14 compared to HIV-uninfected persons. Conclusions: Subclinical CVD was similar in HIV controllers, LTNPs and HIV-uninfected individuals despite elevated levels of some inflammatory biomarkers. Future studies of HIV controllers and LTNPs are needed to characterize the risk of CVD among HIV-infected persons.

    Research areas

  • AIDS, HIV, carotid atherosclerosis, coronary atherosclerosis, subclinical cardiovascular disease

Citation formats


Brusca, R. M., Hanna, D. B., Wada, N. I., Blankson, J. N., Witt, M. D., Jacobson, L. P., ... Post, W. S. (2020). Subclinical cardiovascular disease in HIV controller and long-term nonprogressor populations. HIV Medicine, 21(4), 217-227.


Brusca, RM, Hanna, DB, Wada, NI, Blankson, JN, Witt, MD, Jacobson, LP, Kingsley, L, Palella, FJ, Budoff, M, Brown, TT, Anastos, K, Lazar, JM, Mack, WJ, Bacchetti, P, Tien, PC, Golzar, Y, Plankey, M, Golub, E, Kaplan, RC & Post, WS 2020, 'Subclinical cardiovascular disease in HIV controller and long-term nonprogressor populations', HIV Medicine, vol. 21, no. 4, pp. 217-227.