Elevated cardiovascular risk in people with HIV: the association with coronary artery calcification and endothelial dysfunction.

OBJECTIVE

This study aimed to assess the burden, severity, and pattern of coronary artery disease (CAD) in people with HIV (PWH), as well as its relationship with metabolic syndrome, inflammation, and endothelial dysfunction.

DESIGN

Cross-sectional study.

METHODS

A comparative cross-sectional study was conducted on 72 PWH and 72 matched people without HIV at Aminu Kano Teaching Hospital (AKTH), in Kano, northern Nigeria. Data collection included demographics, metabolic parameters, viral load, brachial artery flow-mediated dilation (BAFMD) assessed via ultrasound, and coronary artery calcification (CAC) scores obtained using electrocardiogram (ECG)-gated computed tomography. CAD predictors were analyzed using t tests, linear regression, and chi-squared/Fisher's exact tests ( P  ≤ 0.05).

RESULTS

Among 144 participants (72 PWH, 72 controls), PWH had higher CAD prevalence (31.9 vs. 4.2%, P  < 0.001) and mean CAC scores (23.2 vs. 2.7, P  < 0.001). CAD was significantly associated with longer ART duration ( P  = 0.04), higher BMI ( P  = 0.005), and reduced BAFMD ( P  = 0.020). In controls, hs-CRP predicted CAD ( P  = 0.004).

CONCLUSION

PWH in northern Nigeria have a higher burden of CAD compared to HIV-negative controls, with greater CAC and endothelial dysfunction, independent of viral load status. These findings highlight the need for routine cardiovascular screening and integration of cardiovascular disease prevention into HIV care.