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- Ensayo clínico NCT00455793
Subclinical Atherosclerosis in HIV-infected Patients
We will obtain data using multi-slice CT technology to detect subclinical coronary disease in the HIV population. Determination of subclinical cardiovascular disease using noninvasive technology and elucidation of the associated risk factors will help to guide targeted therapy to prevent cardiovascular events in this patient population.
We will investigate the prevalence of coronary plaque lesions and coronary artery calcifications in men and women with HIV disease as determined by 64-row multidetector computed tomography (MDCT) and MDCT coronary angiography in comparison to age-matched control subjects without HIV infection. We hypothesize that evidence of coronary artery calcification and coronary plaque lesions as seen by MDCT will be present in individuals with HIV more than non-HIV control subjects of the same age. We also hypothesize the degree of atherosclerosis will be increased in HIV patients compared to control subjects.
We will evaluate the metabolic and inflammatory factors associated with coronary artery disease in HIV-infected individuals. We hypothesize that traditional cardiac risk factors as well as metabolic and inflammatory changes associated with HIV and its treatment such as dyslipidemia, increased secretion of inflammatory markers, decreased adiponectin, increased insulin resistance and increased visceral fat may be associated with coronary artery disease in HIV-infected individuals.
Descripción general del estudio
Estado
Condiciones
Tipo de estudio
Inscripción (Actual)
Contactos y Ubicaciones
Ubicaciones de estudio
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Massachusetts
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Boston, Massachusetts, Estados Unidos, 02114
- Massachusetts General Hospital
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Método de muestreo
Población de estudio
Descripción
Inclusion criteria for HIV infected subjects arm:
- Men and women age 18-60
- BMI 20-35
- Previously documented HIV disease for 5 years or longer either on stable highly active anti-retroviral therapy (HAART) or not on HAART.
- No changes in antiretroviral regimen within the prior 3 months.
Inclusion criteria for non-HIV infected control subjects arm:
- Healthy men and women age 18-60
- BMI 20-35
Exclusion criteria for both arms:
- Previously diagnosed coronary artery disease, cerebrovascular disease, or peripheral vascular disease.
- Use of glucocorticoids, growth hormone, testosterone, or other anabolic agents within past 6 months
- Renal disease or creatinine >1.5 mg/dL
- Anti-inflammatory medications
- Opportunistic infection within past 6 months in HIV infected individuals and current acute infectious illness in both HIV-infected subjects and normal controls.
- Nitrates or others medications that can alter endothelial function
- Contraindication to beta-blocker use
- Body weight greater than 300 lbs due to DEXA scanner table limitations
- Patients with previous allergic reactions to iodine-containing contrast media or to iodine will be excluded from participation
- Active illicit drug use
- Pregnancy or breastfeeding
- Estrogen or progestin use
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Perspectivas temporales: Transversal
Cohortes e Intervenciones
Grupo / Cohorte |
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1
HIV
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2
Non-HIV infected controls
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
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Coronary Plaque
Periodo de tiempo: Baseline
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Baseline
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Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
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Inflammatory indices, glucose homeostasis, body composition
Periodo de tiempo: Baseline
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Baseline
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Steven Grinspoon, MGH
Publicaciones y enlaces útiles
Publicaciones Generales
- Sim JH, Sherman JB, Stanley TL, Corey KE, Fitch KV, Looby SE, Robinson JA, Lu MT, Burdo TH, Lo J. Pro-Inflammatory Interleukin-18 is Associated with Hepatic Steatosis and Elevated Liver Enzymes in People with HIV Monoinfection. AIDS Res Hum Retroviruses. 2021 May;37(5):385-390. doi: 10.1089/AID.2020.0177. Epub 2021 Jan 25.
- Cheru LT, Saylor CF, Fitch KV, Looby SE, Lu M, Hoffmann U, Stanley TL, Lo J. Low vitamin D is associated with coronary atherosclerosis in women with HIV. Antivir Ther. 2019;24(7):505-512. doi: 10.3851/IMP3336.
- Fourman LT, Saylor CF, Cheru L, Fitch K, Looby S, Keller K, Robinson JA, Hoffmann U, Lu MT, Burdo T, Lo J. Anti-Inflammatory Interleukin 10 Inversely Relates to Coronary Atherosclerosis in Persons With Human Immunodeficiency Virus. J Infect Dis. 2020 Feb 3;221(4):510-515. doi: 10.1093/infdis/jiz254.
- Weiss JJ, Sanchez L, Hubbard J, Lo J, Grinspoon SK, Fitch KV. Diet Quality Is Low and Differs by Sex in People with HIV. J Nutr. 2019 Jan 1;149(1):78-87. doi: 10.1093/jn/nxy241.
- Cheru LT, Park EA, Saylor CF, Burdo TH, Fitch KV, Looby S, Weiner J, Robinson JA, Hubbard J, Torriani M, Lo J. I-FABP Is Higher in People With Chronic HIV Than Elite Controllers, Related to Sugar and Fatty Acid Intake and Inversely Related to Body Fat in People With HIV. Open Forum Infect Dis. 2018 Nov 5;5(11):ofy288. doi: 10.1093/ofid/ofy288. eCollection 2018 Nov.
- Srinivasa S, Fitch KV, Torriani M, Zanni MV, Defilippi C, Christenson R, Maehler P, Looby SE, Lo J, Grinspoon SK. Relationship of visceral and subcutaneous adipose depots to markers of arterial injury and inflammation among individuals with HIV. AIDS. 2019 Feb 1;33(2):229-236. doi: 10.1097/QAD.0000000000002060.
- Zanni MV, Stone LA, Toribio M, Rimmelin DE, Robinson J, Burdo TH, Williams K, Fitch KV, Lo J, Grinspoon SK. Proprotein Convertase Subtilisin/Kexin 9 Levels in Relation to Systemic Immune Activation and Subclinical Coronary Plaque in HIV. Open Forum Infect Dis. 2017 Oct 14;4(4):ofx227. doi: 10.1093/ofid/ofx227. eCollection 2017 Fall.
- Srinivasa S, Lu MT, Fitch KV, Hallett TR, O'Malley TK, Stone LA, Martin A, Coromilas AJ, Burdo TH, Triant VA, Lo J, Looby SE, Neilan TG, Zanni MV. Epicardial adipose tissue volume and cardiovascular risk indices among asymptomatic women with and without HIV. Antivir Ther. 2018;23(1):1-9. doi: 10.3851/IMP3193.
- Fitch KV, DeFilippi C, Christenson R, Srinivasa S, Lee H, Lo J, Lu MT, Wong K, Petrow E, Sanchez L, Looby SE, Hoffmann U, Zanni M, Grinspoon SK. Subclinical myocyte injury, fibrosis and strain in relationship to coronary plaque in asymptomatic HIV-infected individuals. AIDS. 2016 Sep 10;30(14):2205-14. doi: 10.1097/QAD.0000000000001186.
- Looby SE, Fitch KV, Srinivasa S, Lo J, Rafferty D, Martin A, Currier JC, Grinspoon S, Zanni MV. Reduced ovarian reserve relates to monocyte activation and subclinical coronary atherosclerotic plaque in women with HIV. AIDS. 2016 Jan 28;30(3):383-93. doi: 10.1097/QAD.0000000000000902.
- Zanni MV, Kelesidis T, Fitzgerald ML, Lo J, Abbara S, Wai B, Marmarelis E, Hernandez NJ, Yang OO, Currier JS, Grinspoon SK. HDL redox activity is increased in HIV-infected men in association with macrophage activation and non-calcified coronary atherosclerotic plaque. Antivir Ther. 2014;19(8):805-811. doi: 10.3851/IMP2756. Epub 2014 Feb 17.
- Fitch KV, Srinivasa S, Abbara S, Burdo TH, Williams KC, Eneh P, Lo J, Grinspoon SK. Noncalcified coronary atherosclerotic plaque and immune activation in HIV-infected women. J Infect Dis. 2013 Dec 1;208(11):1737-46. doi: 10.1093/infdis/jit508. Epub 2013 Sep 16.
- Hwang JJ, Wei J, Abbara S, Grinspoon SK, Lo J. Receptor activator of nuclear factor-kappaB ligand (RANKL) and its relationship to coronary atherosclerosis in HIV patients. J Acquir Immune Defic Syndr. 2012 Nov 1;61(3):359-63. doi: 10.1097/QAI.0b013e31826a6c16.
- Burdo TH, Lo J, Abbara S, Wei J, DeLelys ME, Preffer F, Rosenberg ES, Williams KC, Grinspoon S. Soluble CD163, a novel marker of activated macrophages, is elevated and associated with noncalcified coronary plaque in HIV-infected patients. J Infect Dis. 2011 Oct 15;204(8):1227-36. doi: 10.1093/infdis/jir520.
- Lo J, Abbara S, Rocha-Filho JA, Shturman L, Wei J, Grinspoon SK. Increased epicardial adipose tissue volume in HIV-infected men and relationships to body composition and metabolic parameters. AIDS. 2010 Aug 24;24(13):2127-30. doi: 10.1097/QAD.0b013e32833c055a.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
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Última verificación
Más información
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Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 2006-P-000238
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