{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:31:56Z","timestamp":1767918716511,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,5,25]],"date-time":"2012-05-25T00:00:00Z","timestamp":1337904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Enhanced inflammation is evident in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> infection, even with virological suppression. Outside <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> infection, studies show an independent association between higher total bilirubin and better endothelial function as well as a lower prevalence of coronary heart disease, possibly as a consequence of the anti\u2010inflammatory and antioxidant effect of bilirubin. The aim of this study was to determine whether such an association exists in HIV\u2010infected individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study was performed in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u20101\u2010infected adults on stable antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>) to determine if a relationship exists between total bilirubin and endothelial function [flow\u2010mediated dilation (<jats:styled-content style=\"fixed-case\">FMD<\/jats:styled-content>) of the brachial artery], inflammation [interleukin\u20106 (<jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\u20106), soluble tumour necrosis factor receptors, <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u2010reactive protein, and adhesion molecules], coagulation markers (fibrinogen and <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>\u2010dimer) and oxidative stress (<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>\n<jats:sub>2<\/jats:sub>\u2010isoprostanes). Endpoints were compared based on total bilirubin levels and atazanavir status using distributionally appropriate, two\u2010sample tests. Correlation coefficients were determined between total bilirubin and endpoints. Linear regression was used to model the relationship between total bilirubin (and atazanavir status) and <jats:styled-content style=\"fixed-case\">FMD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 98 adults were included in the study. Total bilirubin was higher in the atazanavir group when compared to the non\u2010atazanavir group [median (interquartile range) 1.8 (1.1\u20132.6) <jats:italic>vs.<\/jats:italic> 0.6 (0.4\u20131.4) mg\/dL; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01] as were insulin, the homeostasis model assessment of insulin resistance (<jats:styled-content style=\"fixed-case\">HOMA\u2010IR<\/jats:styled-content>) and fibrinogen. Total bilirubin was positively correlated with fibrinogen and was not correlated with other outcomes. After adjustment, neither total bilirubin nor atazanavir status was associated with <jats:styled-content style=\"fixed-case\">FMD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In virologically suppressed, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected adults on stable <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>, neither total bilirubin nor atazanavir use was associated with improved endothelial function as measured using <jats:styled-content style=\"fixed-case\">FMD<\/jats:styled-content>, inflammation or oxidative stress as measured using biomarkers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1468-1293.2012.01026.x","type":"journal-article","created":{"date-parts":[[2012,5,25]],"date-time":"2012-05-25T10:37:16Z","timestamp":1337942236000},"page":"609-616","source":"Crossref","is-referenced-by-count":19,"title":["Relationship between total bilirubin and endothelial function, inflammation and oxidative stress in <scp>HIV<\/scp>\u2010infected adults on stable antiretroviral therapy"],"prefix":"10.1111","volume":"13","author":[{"given":"CO","family":"Hileman","sequence":"first","affiliation":[{"name":"MetroHealth Medical Center  Cleveland OH USA"},{"name":"Case Western Reserve University  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CT","family":"Longenecker","sequence":"additional","affiliation":[{"name":"Case Western Reserve University  Cleveland OH USA"},{"name":"University Hospitals Case Medical Center  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TL","family":"Carman","sequence":"additional","affiliation":[{"name":"Case Western Reserve University  Cleveland OH USA"},{"name":"University Hospitals Case Medical Center  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GL","family":"Milne","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DE","family":"Labbato","sequence":"additional","affiliation":[{"name":"Case Western Reserve University  Cleveland OH USA"},{"name":"University Hospitals Case Medical Center  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NJ","family":"Storer","sequence":"additional","affiliation":[{"name":"Case Western Reserve University  Cleveland OH USA"},{"name":"University Hospitals Case Medical Center  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CA","family":"White","sequence":"additional","affiliation":[{"name":"University Hospitals Case Medical Center  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GA","family":"McComsey","sequence":"additional","affiliation":[{"name":"Case Western Reserve University  Cleveland OH USA"},{"name":"University Hospitals Case Medical Center  Cleveland OH 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