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High prevalence of peripheral arterial disease in HIV-infected persons.
- Source :
-
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2008 Mar 01; Vol. 46 (5), pp. 761-7. - Publication Year :
- 2008
-
Abstract
- Background: Atherosclerosis has been assessed in human immunodeficiency virus (HIV)-infected persons by using various methods. Peripheral arterial disease (PAD) has not been evaluated, however. We studied the cross-sectional prevalence of lower limb PAD in an HIV-infected population.<br />Methods: PAD was assessed using the Edinburgh Claudication Questionnaire and by measuring the systolic ankle-brachial blood pressure index (ABI) at rest and after exercise. Patients with PAD were further evaluated by duplex scan of lower limb arteries.<br />Results: Ninety-two consecutive HIV-infected patients were evaluated (23.9% women; mean age, 49.5 years; 61.9% current smokers). Claudication was reported by 15.2% of the patients. PAD was found in 20.7% of the patients: 9.8% had an abnormal ABI (<0.90) at rest, and 10.9% had normal ABI at rest but a >25% decrease after exercise. Of the patients with PAD, 84.2% were investigated with duplex scan, all of whom had atherosclerotic occlusions or stenoses of the iliac or femoral arteries. Age, diabetes, smoking, and low CD4+ T lymphocyte counts were identified as independent predictors of PAD.<br />Conclusions: The prevalence of symptomatic and asymptomatic PAD is high in the HIV-infected population and is much higher than expected (prevalence in the general population, approximately 3% at 60 years). This study suggests the presence of an epidemic of PAD approximately 20 years earlier in the HIV-infected than in the general population. Larger epidemiological studies are needed to better define risk factors and to evaluate whether PAD is associated with increased mortality, as it is in the general population.
- Subjects :
- Adult
Age Factors
Atherosclerosis diagnosis
Atherosclerosis epidemiology
Blood Pressure Determination
CD4 Lymphocyte Count
Constriction, Pathologic diagnosis
Constriction, Pathologic epidemiology
Cross-Sectional Studies
Diabetes Mellitus
Female
Femoral Artery diagnostic imaging
Humans
Iliac Artery diagnostic imaging
Male
Middle Aged
Prevalence
Prospective Studies
Risk Factors
Smoking
Surveys and Questionnaires
Ultrasonography
HIV Infections complications
Peripheral Vascular Diseases epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6591
- Volume :
- 46
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
- Publication Type :
- Academic Journal
- Accession number :
- 18230043
- Full Text :
- https://doi.org/10.1086/527564