Subclinical carotid atherosclerosis and cardiovascular risk factors in HIV-infected patients.

BACKGROUND

HIV infected patients, especially those treated with antiretroviral (ARV) drugs, show an increased risk and incidence of cardiovascular disease.

OBJECTIVES

The aim of this study was to evaluate the progression of subclinical atherosclerosis in the carotid arteries, expressed as the value of carotid intima-media thickness (cIMT) and the amount of atherosclerotic plaques, and to analyze the correlation between cIMT and risk factors for cardiovascular diseases in a cohort of HIV infected patients.

METHODS

The analysis included 72 HIV infected patients, mean age 39.4 years, and 27 healthy HIV negative individuals, matched for age and sex. The data collected included evaluation of the infection, ARV treatment, past cardiovascular events, assessment of traditional and nontraditional risk factors for cardiovascular diseases, cIMT measurements and amount of atherosclerotic plaques in the carotid arteries.

RESULTS

HIV infected patients show more advanced subclinical atherosclerosis in the carotid arteries (cIMT and plaques incidence). The cardiovascular risk profile of the HIV infected patients is significantly different from HIV negative people. Among the HIV positive group lower body mass index (BMI) and higher waist/hip ratio (WHR) are observed. The concentration of all cholesterol fractions is lower, whereas the concentration of triglycerides is higher. Cigarette smoking is more common among HIV-infected individuals. A strong statistical correlation between cIMT and age, hypertension, non-high-density lipoprotein (non-HDL) cholesterol and ARV time were found. Total and LDL cholesterol, and lifetime smoking exposure also affect the cIMT. The relationship between cIMT and current HIV RNA may indicate the impact of the current infection status on the cIMT dynamics in this subpopulation.