Background: HIV is associated with end-organ diseases of aging via unclear mechanisms. Longitudinally
assessing how HIV infection and ART initiation affect biomarkers of end organ function/disease could clarify these
mechanisms. We investigated longitudinal changes in clinical biomarkers following 1) HIV infection and 2) ART
initiation with evidence of viral suppression.
Methods: Cohort: Veterans Aging Cohort Study Virtual Cohort (VACS VC). VACS VC is a longitudinal cohort of HIV
infected (HIV+) and race-ethnicity, sex, age, and clinical site-matched uninfected Veterans enrolled in the same calendar
year. Inclusion criteria: a negative and successively positive (>six months) HIV antibody test. We used Wilcoxon signedrank
tests to analyze 1) the effect of HIV infection on lipids, renal, hepatic and hematologic/cardiovascular biomarkers
and 2)whether ART initiation with HIV-1 RNA<500 cpm reverts any changes back to pre-HIV levels.
Results: 422 Veterans had at least 1 biomarker measurement available prior to HIV infection and prior to ART initiation.
297 had at least 1 biomarker measurement available prior to HIV infection and after ART initiation with evidence of viral
suppression. Mean age prior to HIV infection was 43 years. HIV infection was associated with reduction in total
cholesterol, HDL cholesterol, LDL cholesterol, serum albumin, ALT, platelet count, hemoglobin and elevation of FIB-4
score and triglycerides. These changes occurred without significant changes in BMI. ART initiation (with HIV-1
RNA<500cpm) did not reverse alteration in triglycerides, LDL cholesterol, hemoglobin, or FIB-4 to pre-HIV infection
Conclusions: HIV infection is associated with longitudinal changes in serum levels of several biomarkers of end-organ
function/disease and mortality. Multiple biomarkers (triglycerides, LDL cholesterol, hemoglobin, and FIB-4 ) remain
altered from levels prior to HIV infection levels even following inititiation of ART and evidence of viral suppression.
These results give insights into underlying mechanisms of increased risk for aging-related chronic diseases in the context
of HIV infection.