Increased prevalence of clonal hematopoiesis of indeterminate potential amongst people living with HIV. Scientific Reports
Clonal hematopoiesis of indeterminate potential (CHIP), the age-related acquisition and expansion of hematopoietic stem cells due to leukemogenic driver mutations, increases risk for both hematologic malignancy and coronary artery disease (CAD).
In the current study, Bick et al. aimed to assess whether people living with HIV (PLWH) have a greater prevalence of CHIP compared to other risk groups.
The authors searched for CHIP in multi-ethnic cases from the Swiss HIV Cohort Study (SHCS, n= 600) and controls from the Atherosclerosis Risk in the Communities study (ARIC, n= 8111) from blood DNA-derived exome sequences. They observed that HIV is associated with a twofold increase in CHIP prevalence, both in the whole study population and in a subset of 230 cases and 1002 matched controls selected by propensity matching to control for demographic imbalances (SHCS 7%, ARIC 3%, p = 0.005). They also observed that ASXL1 is the most commonly mutated CHIP-associated gene in PLWH.
In conclusion, the study suggests that CHIP may contribute to the excess cardiovascular risk observed in PLWH. Since PLWH have accelerated biologic aging, CHIP detection may represent a new opportunity for identification of at-risk patients with particular relevance for HIV medicine. Conversely, PLWH may provide a rich source of information to understand mechanisms of clonal expansion of different CHIP-associated variants under long-term low-grade inflammation.