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Progression of atherosclerosis as assessed by carotid intima-media thickness in patients with HIV infection.
- Source :
-
Circulation [Circulation] 2004 Apr 06; Vol. 109 (13), pp. 1603-8. Date of Electronic Publication: 2004 Mar 15. - Publication Year :
- 2004
-
Abstract
- Background: HIV-infected patients may be at increased risk for coronary events. The purpose of this study was to identify predictors of carotid intima-media thickness (IMT) in HIV patients at baseline and to measure IMT progression over 1 year.<br />Methods and Results: We measured blood lipids, inflammatory markers, and IMT in 148 HIV-infected adults (mean age, 45+/-8 years) and in 63 age- and sex-matched HIV-uninfected control subjects. The mean duration of HIV infection was 11 years, and the median duration of protease inhibitor treatment was 3.3 years. Mean baseline IMT was 0.91+/-0.33 mm in HIV patients and 0.74+/-0.17 mm in control subjects (P=0.0001). Multivariable predictors of baseline IMT in HIV patients were age (P<0.001), LDL cholesterol (P<0.001), cigarette pack-years (P=0.005), Latino race (P=0.062), and hypertension (P=0.074). When the control group was added to the analysis, HIV infection was an independent predictor of IMT (P=0.001). The rate of progression among the 121 HIV patients with a repeated IMT measurement at 1 year was 0.074+/-0.13 mm, compared with -0.006+/-0.05 mm in 27 control subjects (P=0.002). Age (P<0.001), Latino race (P=0.02), and nadir CD4 count < or =200 (P=0.082) were multivariable predictors of IMT progression.<br />Conclusions: Carotid IMT is higher in HIV patients than in age-matched control subjects and progresses much more rapidly than previously reported rates in non-HIV cohorts. In HIV patients, carotid IMT is associated with classic coronary risk factors and with nadir CD4 count < or =200, suggesting that immunodeficiency and traditional coronary risk factors may contribute to atherosclerosis.
- Subjects :
- Adult
Biomarkers
CD4 Lymphocyte Count
California epidemiology
Carotid Artery Diseases diagnostic imaging
Carotid Artery Diseases pathology
Carotid Stenosis diagnostic imaging
Carotid Stenosis pathology
Carotid Stenosis surgery
Cohort Studies
Coronary Artery Bypass statistics & numerical data
Disease Progression
Female
Follow-Up Studies
Humans
Hypertension complications
Inflammation blood
Inflammation complications
Inflammation pathology
Lipids blood
Male
Middle Aged
Risk Factors
Smoking
Tunica Intima diagnostic imaging
Tunica Media diagnostic imaging
Ultrasonography
Carotid Artery Diseases complications
Carotid Stenosis etiology
HIV Infections complications
Tunica Intima pathology
Tunica Media pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4539
- Volume :
- 109
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 15023877
- Full Text :
- https://doi.org/10.1161/01.CIR.0000124480.32233.8A