Chronic Immune Activation Biomarkers and Cardiovascular Disease Risk in Individuals with HIV Infection and Type 1 Diabetes Mellitus

Kintuza Lumwako Tebulo

Faculty of Medicine Kampala International University Uganda

ABSTRACT

Chronic immune activation represented a hallmark pathophysiological feature of both HIV infection and type 1 diabetes mellitus, characterized by persistent elevation of inflammatory cytokines, activated immune cell populations, and acute-phase reactants despite effective disease management. People living with HIV demonstrated sustained immune dysregulation even with virological suppression on antiretroviral therapy, while type 1 diabetes generated chronic inflammation through autoimmune mechanisms, hyperglycemia-induced oxidative stress, and advanced glycation end-product accumulation. These inflammatory pathways converged on vascular endothelium, accelerating atherosclerosis and elevating cardiovascular disease risk beyond traditional risk factors. This review critically evaluated the current evidence regarding chronic immune activation biomarkers as predictors of cardiovascular disease risk in individuals with both HIV infection and type 1 diabetes, examining mechanistic links, biomarker profiles, clinical associations, and risk stratification utility. A comprehensive literature search of PubMed, EMBASE, Web of Science, and clinical trial databases was conducted for peer-reviewed studies published between 2012 and 2025 investigating immune activation biomarkers and cardiovascular outcomes in HIV-diabetes comorbidity. Key biomarkers including high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, soluble CD14, soluble CD163, D-dimer, and oxidized low-density lipoprotein demonstrate synergistic elevations in HIV-type 1 diabetes comorbidity, correlating with subclinical atherosclerosis, endothelial dysfunction, and cardiovascular events. Individuals with both conditions exhibit 3.5 to 5.8-fold increased cardiovascular disease risk compared to HIV or diabetes alone, with biomarker levels predicting outcomes independent of traditional risk factors. However, evidence derived predominantly from cross-sectional studies and small cohorts with limited longitudinal follow-up. Chronic immune activation biomarkers provided mechanistic insights and prognostic value for cardiovascular risk assessment in HIV-type 1 diabetes comorbidity, though standardized measurement protocols and interventional trials targeting inflammation are needed.

Keywords: Immune activation, Cardiovascular disease, HIV infection, Type 1 diabetes mellitus, Inflammatory biomarkers.

 

CITE AS: Kintuza Lumwako Tebulo. (2026). Chronic Immune Activation Biomarkers and Cardiovascular Disease Risk in Individuals with HIV Infection and Type 1 Diabetes Mellitus. IDOSR JOURNAL OF BIOLOGY, CHEMISTRY AND PHARMACY 11(1):111-117. https://doi.org/10.59298/IDOSR/JBCP/26/102.111117