Elevated plasma apolipoprotein E levels in people living with HIV: Associations with biomarkers and HIV-specific risk factors

Anne Marie Reimer Jensen, Ruth Frikke-Schmidt, Marco Gelpi, Andreas D. Knudsen, Thomas Benfield, Børge G. Nordestgaard, Shoaib Afzal, Tor Biering-Sørensen, Susanne Dam Nielsen*

*Corresponding author for this work

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Abstract

Background and aims: Apolipoprotein E (apoE) plays a crucial role in cholesterol metabolism, and high levels of apoE in plasma are associated with cardiovascular disease and all-cause mortality. We aimed to assess if HIV is independently associated with high plasma apoE and to determine HIV-related risk factors for high plasma apoE. Methods: We included 661 people with HIV (PWH) from the Copenhagen Comorbidity in HIV (COCOMO) study with available measurement of plasma apoE. COCOMO participants were frequency matched 1:1 on age and sex with controls from the Copenhagen General Population Study. High plasma apoE was defined as levels above the 90th percentile (66.2 mg/L). The association between HIV and high plasma apoE was assessed using logistic regression models. Among PWH, both linear and logistic regression models were used to determine HIV-specific risk factors for high plasma apoE. Results: Mean age was 52 years and 89 % were male. Median plasma apoE was 49.0 mg/L in PWH and 43.3 mg/L in controls, p < 0.001. HIV was associated with higher plasma apoE after adjusting for potential confounders, including triglycerides (odds ratio 2.14 [95 % CI: 1.39–3.29], p < 0.001). In PWH, higher plasma apoE was associated with a previous AIDS-defining condition in linear models before adjustment for triglycerides and integrase strand transfer inhibitor use in fully adjusted linear models. Conclusions: PWH had higher plasma apoE than controls even after adjusting for triglycerides. Further studies are needed to elucidate the clinical impact of high plasma apoE in PWH.

Original languageEnglish
Article number117457
JournalAtherosclerosis
Volume390
Number of pages6
ISSN0021-9150
DOIs
Publication statusPublished - 2024

Bibliographical note

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© 2024 The Authors

Keywords

  • Antiretroviral treatment
  • APOE
  • Apolipoprotein E
  • HIV
  • Human immunodeficiency virus
  • Triglycerides

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