Metabolomic and transcriptomic features of the cardiometabolic disease spectrum in people living with HIV.

Background: Human immunodeficiency virus (HIV) infection is associated with significant metabolic disruptions, and understanding how these disruptions contribute to cardiovascular disease (CVD) is essential for improving patient management and therapeutic strategies. By integrating metabolomics and transcriptomics, we aimed to elucidate the cardiometabolic disease spectrum of people living with HIV (PLWH) and to identify biomarkers and pathways associated with disease progression in this population. Methods: We conducted a cross-sectional observational study between October 2022 and June 2023 at the Third People's Hospital of Shenzhen, China. Participants were categorized into one of four groups: HIV+ without metabolic abnormalities (healthy control [HC]), HIV + with untreated metabolic (UM) abnormalities (HIV + UM), HIV + with treated metabolic (TM) abnormalities (HIV + TM), and HIV + with CVD (HIV + CVD). Key metabolic and transcriptomic features were identified through a comparative analysis using untargeted metabolomics and RNA sequencing, followed by statistical and pathway enrichment analyses. Results: This study included 114 PLWH: HC group ( Conclusions: This study identified key metabolic and transcriptomic alterations associated with CVD among PLWH. These alterations, primarily driven by immune activation, inflammation, and metabolic dysregulation, reflect unique molecular characteristics of CVD in PLWH. Our findings underscore the importance of early detection and tailored interventions to manage CVD risk in this population, providing insights into potential biomarkers for disease progression.