People living with HIV (PLWH) are at increased risk for premature cardiovascular disease (CVD). Clonal hematopoiesis (CH) is a common age-related condition that may be associated with increased CVD risk. The goal of this study was to determine the prevalence of CH and its association with chronic inflammation and CVD in PLWH.
Cross-sectional study utilizing archived specimens and data from 118 men (86 PLWH and 32 HIV-uninfected) from the Baltimore-Washington DC center of the Multicenter AIDS Cohort Study (MACS) who had had coronary computed tomography angiography (CTA) and measurement of 34 serologic inflammatory biomarkers.
CH was assessed on peripheral blood mononuclear cells utilizing targeted error-corrected next generation sequencing (NGS) focused on 92 genes frequently mutated in hematologic malignancies. Clinical and laboratory data were obtained from the MACS database.
CH with a variant allele frequency (VAF) >1% was significantly more common in PLWH [20/86 (23.3%)] than in HIV-uninfected men [2/32 (6.3%)] (p = 0.035). PLWH with CH (VAF>1%) were more likely to have coronary artery stenosis ≥ 50% than those without CH (6/20 (30%) vs. 6/64 (9%); p = 0.021). Presence of CH was not significantly associated with serological inflammatory markers, except for significantly lower serum leptin levels; this was not significant after adjustment for abdominal or thigh subcutaneous fat area.
CH was more common in PLWH and among PLWH was associated with the extent of coronary artery disease. Larger studies are needed to further examine the biological and clinical consequences of CH in PLWH.