The Impact of Clonal Hematopoiesis on Cardiovascular Disease in People Living with HIV

• Published in: Experimental hematology 2022-08, Vol.114, p.18-21
• Main Authors: Wiley, Brian, Parsons, Tyler M., Burkart, Samantha, Young, Andrew L., Erlandson, Kristine M., Tassiopoulos, Katherine K., Wu, Kunling, Gurnett, Christina, Presti, Rachel M., Bolton, Kelly L., Challen, Grant A.
• Format: Article
• Language: English
• ISSN: 0301-472X; 1873-2399
• DOI: 10.1016/j.exphem.2022.07.304

Hematopoietic stem cells (HSCs) with age-associated somatic mutations that disproportionally contribute to hematopoiesis generate the condition known as clonal hematopoiesis (CH). While CH conveys increased risk of hematologic cancer, there is also strong association between CH and cardiovascular disease (CVD). Accumulating evidence suggests that inflammation mechanistically links CH to CVD, and we hypothesized that CH may be a predictive biomarker of CVD in conditions of chronic inflammation. One such patient population is people living with HIV (PLWH) who also have substantially increased incidence of CVD and CH [ 1 ]. We studied the association between CH and CVD in PLWH using samples from ACTG Study A5001 (or ALLRT), a prospective clinical trial of HIV-infected persons with long term follow-up. We observed a positive association between CH and CVD in PLWH independent of traditional CVD risk factors. Moreover, in CVD cases the CH clone was identifiable in the blood years prior to CVD diagnosis, unlike PLWH with CH who did not suffer CVD. With the lifespan of PLWH increasing due to advances in treatment, our results indicate that the presence of CH and its clonal dynamics could be used as a prognostic biomarker to risk of CVD in PLWH.