Elevations in
C-reactive protein (CRP) are associated with increased
cardiovascular disease (CVD) risk, increased HIV
disease progression, and death in HIV-infected patients. Use of
abacavir has been reported to increase CVD risk. We assessed the effect of virologically suppressive
efavirenz (EFV)-based antiretroviral
therapy on high sensitivity CRP (
hsCRP) levels over a 96-week period with particular attention to the effect of gender and
abacavir use. Banked sera from entry and week 96 visits of
AIDS Clinical Trials Group A5095 participants were assayed for
hsCRP, then analyzed by gender,
abacavir randomization, and for correlation with changes in fasting metabolic parameters. Analyses of
hsCRP were conducted in two phases and involved a total of 145 men and 51 women.
hsCRP did not differ by gender at baseline but higher levels were seen at week 96 in women (median 6 mg/liter; Q1, Q3, 1.8, 13.8) compared to men (median 1.6 mg/liter; Q1, Q3, 0.9, 4.2, p < 0.001), with an estimated shift in
hsCRP by gender of 2.5 mg/liter (95% CI 1.0, 5.1). There was no difference in
hsCRP levels by
abacavir use. Changes in
hsCRP did not correlate with changes in
insulin resistance or with changes in fasting
lipids. Durably virologically suppressive
therapy with EFV-based regimens did not decrease
hsCRP levels over a 96-week period.
hsCRP levels increased significantly only in women. Randomization to
abacavir had no effect on changes in
hsCRP levels. Changes in
hsCRP levels did not correlate with changes in fasting metabolic parameters.