People living with HIV (PLWH) are at risk of noninfectious comorbidities. It is important to individualize those at higher risk. In a single-center cohort of PLWH, we performed a cross-sectional analysis of comorbidities, diagnosed according to standard procedures. The primary endpoint was the prevalence of subclinical carotid/coronary atherosclerosis. Secondary endpoints were its association with selected inflammatory/immune activation biomarkers and with other comorbidities. Associations were examined by using Chi-square or Fisher's exact test for categorical variables and Student or Wilcoxon tests for quantitative variables, and a stepwise multivariate logistical model was performed for further exploration. Among 790 participants [median age: 49.8 years (interquartile range, IQR: 44.5–55.6), 77.1% males, median CD4: 536/mm³ (IQR: 390–754), 83.6% with undetectable viral load], asymptomatic atherosclerosis was found in 26% and was associated in multivariate analysis with older age, longer known duration of infection, higher sCD14, and lower adiponectin levels. Hypertension was found in 33.5% of participants, diabetes in 19.4%, renal impairment in 14.6%, elevated low-density lipoprotein-cholesterol in 13.3%, elevated triglyceride/high-density lipoprotein (HDL)-cholesterol ratio in 6.6%, and osteoporosis in 7.9%. The presence of two or more comorbidities was found in 42.1% of participants and was associated in multivariate analysis with older age and longer exposure to antiretrovirals. Comorbidities were diversely associated with biomarkers: osteoporosis with higher IL-6, renal impairment with higher sCD14, hypertension with higher D-dimer, diabetes and elevated triglyceride/HDL-cholesterol ratio both with lower adiponectin and lower 25-hydroxyvitamin D. Asymptomatic atherosclerosis and multimorbidity were frequent in a cohort of middle-aged, well-controlled, PLWH and were associated with traditional and HIV-specific factors. Associations between morbidities and inflammatory/immune activation biomarkers were diverse.

中文翻译：

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成人 HIV 感染者门诊队列中无症状动脉粥样硬化和其他合并症的患病率：与 HIV 参数和生物标志物的关联

HIV 感染者 (PLWH) 有患非传染性合并症的风险。对高危人群进行个体化处理很重要。在 PLWH 的单中心队列中，我们对根据标准程序诊断的合并症进行了横断面分析。主要终点是亚临床颈动脉/冠状动脉粥样硬化的患病率。次要终点是其与选定的炎症/免疫激活生物标志物和其他合并症的关联。通过对分类变量使用卡方或 Fisher 精确检验以及对定量变量使用 Student 或 Wilcoxon 检验来检查关联，并执行逐步多变量逻辑模型以进行进一步探索。在 790 名参与者中 [中位年龄：49.8 岁（四分位距，IQR：44.5–55.6），77.1% 的男性，中位 CD4：536/mm³(IQR: 390–754)，83.6% 的病毒载量检测不到]，26% 的患者发现无症状动脉粥样硬化，并且在多变量分析中与年龄较大、已知感染持续时间较长、sCD14 较高和脂联素水平较低有关。33.5% 的参与者发现高血压、19.4% 的糖尿病、14.6% 的肾功能损害、13.3% 的低密度脂蛋白胆固醇升高、6.6% 的甘油三酯/高密度脂蛋白 (HDL)-胆固醇比率升高和骨质疏松症7.9%。在 42.1% 的参与者中发现存在两种或多种合并症，并且在多变量分析中与年龄较大和接触抗逆转录病毒药物的时间较长有关。合并症与生物标志物的相关性不同：IL-6 较高的骨质疏松症、sCD14 较高的肾功能损害、D-二聚体较高的高血压、糖尿病和甘油三酯/高密度脂蛋白胆固醇比率升高，同时脂联素和 25-羟基维生素 D 较低。无症状动脉粥样硬化和多发病在控制良好的中年人群中很常见，并且与传统因素和 HIV 特异性因素有关。发病率和炎症/免疫激活生物标志物之间的关联是多种多样的。