Extra-coronary calcification (aortic valve calcification, mitral annular calcification, aortic valve ring calcification and thoracic aortic calcification) in HIV seropositive and seronegative men: Multicenter AIDS Cohort Study

•To our knowledge, this is the first study describing the association between HIV and ECC.•HIV+ men were 70% more likely than HIV-uninfected men to have AVC.•HIV+ men were 3 times more likely to have MAC.•AVC and AV-ring calcification in HIV+ men was associated with non-calcified coronary plaque.

IntroductionPrevious studies have demonstrated an association between HIV infection and coronary artery disease (CAD); little is known about potential associations between HIV infection and extra-coronary calcification (ECC).MethodsWe analyzed 621 HIV infected (HIV+) and 384 HIV uninfected (HIV−) men from the Multicenter AIDS Cohort Study who underwent non-contrast computed tomography (CT) from 2010-2013. Agatston scores were calculated for mitral annular calcification (MAC), aortic valve calcification (AVC), aortic valve ring calcification (AVRC), and thoracic aortic calcification (TAC). The associations between HIV infection and the presence of each type of ECC (score > 0) were evaluated by multivariable logistic regression. We also evaluated the association of ECC with inflammatory biomarker levels and coronary plaque morphology.ResultsAmong HIV+ and HIV− men, the age-standardized prevalences were 15% for TAC (HIV+ 14%/HIV− 16%), 10% for AVC (HIV+ 11%/HIV− 8%), 24% for AVRC (HIV+ 23% HIV− 24%), and 5% for MAC (HIV+ 7%/HIV− 3%). After adjustment, HIV+ men had 3-fold greater odds of MAC compared to HIV− men (OR = 3.2, 95% CI: 1.5–6.7), and almost twice the odds of AVC (1.8, 1.1–2.9). HIV serostatus was not associated with TAC or AVRC. AVRC was associated with higher Il-6 and sCD163 levels. TAC was associated with higher ICAM-1, TNF-α RII, and Il-6 levels. AVC and AVRC calcification were associated with presence of non-calcified plaque in HIV+ but not HIV− men.ConclusionHIV infection is an independent predictor of MAC and AVC. Whether these calcifications predict mortality in HIV+ patients deserves further investigation.