Cardiovascular disease (CVD) risk in people with well-managed human immunodeficiency virus (HIV) is twice as high as in the general population. Excessive visceral adipose tissue (VAT), commonly observed in individuals with HIV, might play a role in this increased risk. To assess this connection, researchers led by Teressa S Thomas have examined the potential of the visceral adiposity index (VAI) to predict cardiometabolic factors among people with HIVas published in Open Forum Infectious Diseases.

The VAI is a calculated score that approximates VAT by combining anthropometric measurements with biochemical markers, eliminating the need for imaging quantification. This study aimed to evaluate the VAI's correlation with cardiometabolic factors in people with HIV who had controlled HIV and increased abdominal VAT, and no known cardiovascular disease.
Key findings from the study include:
• The study included 45 people with HIV who were on antiretroviral therapy and virologically controlled. The participants were mostly male (73%), white (53%), and non-Hispanic (84%), with an average age of 55 years.
• The median VAI calculated for people with HIV was 4.9, with an interquartile range of 2.8 to 7.3.
• The VAI exhibited a strong correlation with VAT (visceral adipose tissue) and various anthropometric measures, such as body mass index (BMI), waist circumference, and waist-to-hip ratio.
•Participants with coronary plaque demonstrated a higher VAI than those without coronary plaque. The median VAI for individuals with coronary plaque was 5.3, compared to 2.8 for those without plaque.
• In receiver operating characteristic (ROC) analyses, the VAI outperformed traditional atherosclerotic CVD risk scores in predicting the presence of coronary plaque. The area under the curve for VAI was 0.760 (P = 0.008).
These findings suggest that the VAI could serve as a valuable biomarker indicating metabolic dysfunction and increased cardiovascular risk associated with VAT accumulation in people with HIV. The VAI's ability to predict the presence of coronary plaque could prove crucial in identifying individuals at higher risk for cardiovascular complications, allowing for targeted interventions and preventative strategies.
The study underscores the importance of understanding the intricate relationships between metabolic factors, visceral adiposity, and cardiovascular health, especially in the context of HIV. As healthcare professionals work to manage and mitigate the cardiovascular risk in people with HIV, biomarkers like the VAI could contribute to more effective risk assessment and tailored interventions. Further research is warranted to validate and expand on these findings to improve the cardiovascular health outcomes of individuals with HIV.
Reference:
Thomas, T. S., Dunderdale, C., Lu, M. T., Walpert, A. R., Shen, G., Young, M. C. H., Torriani, M., Chu, J. T., Haptu, H. H., Manandhar, M., Wurcel, A., Adler, G. K., Grinspoon, S. K., & Srinivasa, S. (2023). Visceral adiposity index as a measure of cardiovascular disease in persons with human immunodeficiency virus. Open Forum Infectious Diseases, 10(8). https://doi.org/10.1093/ofid/ofad398