Ectopic Fat in People Living with HIV and General Populations
Research type
Research Study
Full title
The Association of Ectopic Fat and Cardiovascular Disease in People Living with HIV and General populations: A cross sectional analysis
IRAS ID
337369
Contact name
Thomas Heseltine
Contact email
Sponsor organisation
University of Liverpool
ISRCTN Number
ISRCTN47550369
Duration of Study in the UK
0 years, 11 months, 28 days
Research summary
People living with HIV (PLWHIV) have an increased risk of developing CVD (heart attacks and strokes) compared to risk matched HIV-negative patients. CVD is a leading cause of morbidity and mortality in PLWHIV and increasing burden on healthcare systems. One model has suggested that the median age of PLWHIV will increase from 43.9 years in 2010 to 56.6 years in 2030 with 78% being diagnosed with CVD (Smit et al. 2015). Traditional risk predication tools have been demonstrated to perform poorly in this patient cohort (Soares et al. 2022).
Both non-alcoholic fatty liver disease (NAFLD - fat around the liver) and epicardial adipose tissue (fat around the heart) are increasingly recognised as risk factors for CVD in both PLWHIV and HIV-negative groups. PLWHIV are 25% more likely to develop NAFLD at normal body weights compared to HIV-negative groups. Our work, and others, have demonstrated a significant association of NAFLD and CVD in PLWHIV but less so in HIV-negative groups (Heseltine et al. 2021).
Using one MRI study we are able analyse multiple measures of cardiac structure and function as well as heart muscle integrity, fat around the heart and fat in the liver. We are also able analyse metabolites in the heart muscle to assess the amount of at contained within the heart muscle cells (this technique is called cardiac MR spectroscopy). We have designed this detailed cross-sectional analysis comparing PLWHIV to risk-matched general groups to inform on the role of ectopic fat in CVD in PLWHIV. This is of critical importance to gain mechanistic insight into the excess CVD risk seen in PLWHIV whilst also providing potential therapeutic targets for emerging drugs.
REC name
London - Surrey Research Ethics Committee
REC reference
24/PR/0222
Date of REC Opinion
19 Mar 2024
REC opinion
Further Information Favourable Opinion