Lp(a) predicts carotid artery thickening only in HIV-infected young women, the Women's Interagency HIV Study of 250 participants (Arterioscler Thromb Vasc Biol 2017)

Original title: Lipoprotein(a) and HIV: Allele-Specific Apolipoprotein(a) Levels Predict Carotid Intima-Media Thickness in HIV-Infected Young Women in the Women's Interagency HIV Study

Arterioscler Thromb Vasc Biol · 23 March 2017 · 7

Enkhmaa B, Anuurad E, Zhang W, Li CS, Kaplan R, Lazar J, Merenstein D, Karim R, Aouizerat B, Cohen M, Butler K, Pahwa S et al.

The Women's Interagency HIV Study (WIHS) examined whether Lp(a) and allele-specific apolipoprotein(a) [apo(a)] levels predict carotid artery intima-media thickness in 150 HIV-infected and 100 HIV-uninfected young women (mean age about 31 years, about 70% Black). The prevalence of small apo(a) size (22 Kringle repeats or fewer) or high Lp(a) (30 mg/dL or higher) was similar by HIV status. Total plasma Lp(a) (P=0.029) and allele-specific apo(a) level carried by smaller apo(a) sizes (P=0.022) were significantly associated with carotid intima-media thickness in HIV-infected women only, remaining significant after adjusting for confounders including age, race, smoking, blood pressure, hepatitis C coinfection, lipids, treatment status, CD4+ T cell count and HIV viral load (Lp(a) P=0.035; allele-specific apo(a) P=0.010). No other lipids or lipoproteins were associated with carotid thickness. The findings show Lp(a) and allele-specific apo(a) levels predict carotid artery thickening specifically in HIV-infected young women.

Original abstract

Objective: In the general population, lipoprotein(a) [Lp(a)] has been established as an independent causal risk factor for cardiovascular disease. Lp(a) levels are to a major extent regulated by a size polymorphism in the apolipoprotein(a) [apo(a)] gene. The roles of Lp(a)/apo(a) in human immunodeficiency virus (HIV)-related elevated cardiovascular disease risk remain unclear.

Approach And Results: The associations between total plasma Lp(a) level, allele-specific apo(a) level, an Lp(a) level carried by individual apo(a) alleles, and common carotid artery intima-media thickness were assessed in 150 HIV-infected and 100 HIV-uninfected women in the WIHS (Women's Interagency HIV Study). Linear regression analyses with and without adjustments were used. The cohort was young (mean age, ≈31 years), with the majority being Blacks (≈70%). The prevalence of a small size apo(a) (≤22 Kringle repeats) or a high Lp(a) level (≥30 mg/dL) was similar by HIV status. Total plasma Lp(a) level (P=0.029) and allele-specific apo(a) level carried by the smaller apo(a) sizes (P=0.022) were significantly associated with carotid artery intima-media thickness in the HIV-infected women only. After accounting for confounders (age, race, smoking, body mass index, blood pressure, hepatitis C virus coinfection, menopause, plasma lipids, treatment status, CD4+ T cell count, and HIV/RNA viral load), the association remained significant for both Lp(a) (P=0.035) and allele-specific apo(a) level carried by the smaller apo(a) sizes (P=0.010) in the HIV-infected women. Notably, none of the other lipids/lipoproteins was associated with carotid artery intima-media thickness.

Conclusions: Lp(a) and allele-specific apo(a) levels predict carotid artery intima-media thickness in HIV-infected young women. Further research is needed to identify underlying mechanisms of an increased Lp(a) atherogenicity in HIV infection.

Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.