PI: Claudia Martinez, MD
Primary Mentor: Barry Hurwitz, PhD
Title: Associate Professor of Clinical Medicine, Department of Cardiology, University of Miami Miller School of Medicine

Study Title: DNA Methylation and Cardiovascular Risk in Latinos Living with and without Cocaine Use

Abstract: The prevalence of HIV infection in Latinos is substantial in South Florida. Cardiovascular disease (CVD) has now become a major health issue accounting for the rise in non-AIDS mortality among all persons living with HIV(PLWH). CVD is of particular concern for Latino sin the US, because the prevalence of cardiometabolic complications in this population is elevated relative to non-Hispanic whites. In addition, another CVD risk factor is the increased prevalence of cocaine use in PLWH. Although evidence suggests that cocaine use in the presence of HIV infection would create greater acceleration of CVD, little or no evidence exists delineating the interaction of these influences on subclinical CVD risk among Latinos, a population facing economic disadvantages and health disparities. Our research has focused on the accelerated CVD pathophysiology observed in HIV spectrum disease. We have previously collected a comprehensive set of cardiometabolic indices in an HIV seropositive cohort of Latino men and women, and in addition have samples of stored peripheral blood mononuclear cells. Our preliminary data indicate that current cocaine use in Latino HIV+ men and women confers a disproportionately higher risk for CVD, indexed by the Framingham coronary event risk score. Novel epigenetic biomarkers can help identify underlying biomechanisms that predispose Latino PLWH to CVD. The most widely validated and studied epigenetic marker is DNA methylation (DNAm). DNA mlevels can accurately estimate age of tissues and cells. Methylation of DNA may occur as a consequence of exogenous stimuli such as diet, lifestyle and environmental factors that typically act to repress gene function. Thus, DNA methylation has been considered not only a marker of modified gene function and aging but also a mediator influencing the relationship among modifiable and non-modifiable risk factors and CVD pathophysiology. Using the stored specimens from the participants of our previous research, the proposed study is designed to extend our work by: a) determining the extent to which cocaine use in Latino HIV infected men and women is associated with aging, indexed by DNAm, and; b)examining the extent to which DNAm differentially predicts elevated subclinical cardiometabolic risk among study groups. In a total of 64 Latino HIV+ persons, three groups will be compared including: Latino HIV+ persons who are current cocaine users, Latino HIV+ persons who have previous history of cocaine use but are not current users, and Latino HIV+ counterparts who have no history of cocaine use. Our initiative strives to contribute to the paucity of data on the intersection of HIV infection, substance use, and CVD health disparities among Latinos. Findings from the proposed study will provide the basis for a larger investigation to identify the epigenetic and pathophysiological mechanisms underlying CVD disparities among Latinos living with HIV. Identifying early subclinical pathophysiological changes unique to Latino adults will inform potential avenues of intervention to address their elevated CVD risk burden.