Ultrasonographic measures of cardiovascular disease risk in antiretroviral treatment-naive individuals with HIV infection.

TitleUltrasonographic measures of cardiovascular disease risk in antiretroviral treatment-naive individuals with HIV infection.
Publication TypeJournal Article
Year of Publication2013
AuthorsStein JH, Brown TT, Ribaudo HJ, Chen Y, Yan M, Lauer-Brodell E, McComsey GA, Dubé MP, Murphy RL, Hodis HN, Currier JS
JournalAIDS
Volume27
Issue6
Pagination929-37
Date Published2013 Mar 27
ISSN1473-5571
KeywordsAdult, Cardiovascular Diseases, Carotid Arteries, Cross-Sectional Studies, Female, HIV Infections, Humans, Male, Middle Aged, Risk Assessment
Abstract

OBJECTIVE: To evaluate associations between traditional cardiovascular disease (CVD) risk factors, inflammatory markers and markers of HIV disease activity with ultrasonographic measures of CVD risk in patients with HIV who are not receiving antiretroviral therapy (ART).

DESIGN: Cross-sectional, baseline evaluation of ART-naive HIV-infected individuals without known CVD or diabetes mellitus enrolled in a randomized ART treatment trial.

METHODS: Prior to ART initiation, carotid artery intima-media thickness (CIMT) and brachial artery flow-mediated dilation (FMD) were measured. Additional parameters included CD4 cell count, HIV viral load, body composition, lipoproteins and inflammatory markers. Associations with common CIMT, bifurcation CIMT, presence of carotid artery lesions and brachial artery FMD were evaluated.

RESULTS: The 331 enrolled individuals were a median (first-third quartile) of 36 (28-45) years old. Common and bifurcation CIMT values were higher and lesions more prevalent with older age (P < 0.001). FMD was lower with older age (P = 0.009). Those with a Framingham Risk Score of at least 6% per 10 years (N = 44) had higher common and bifurcation CIMT (P < 0.001), carotid lesion prevalence (P < 0.001) and lower FMD (P = 0.035). Independent associations with common CIMT were identified for increasing age, height, weight, small low-density lipoprotein (LDL) particles and black race; these were similar for bifurcation CIMT. Presence of carotid artery lesions was associated with increasing age, presence of metabolic syndrome, interleukin-6 and lower HIV-1 RNA.

CONCLUSION: In a contemporary cohort of ART-naive HIV-infected individuals, ultrasonographic measures of CVD risk were more strongly associated with traditional risk factors than CD4 cell counts, HIV replication or inflammatory markers.

DOI10.1097/QAD.0b013e32835ce27e
Alternate JournalAIDS
PubMed ID23196938
PubMed Central IDPMC3664137
Grant ListAI 068636 / AI / NIAID NIH HHS / United States
AI068634 / AI / NIAID NIH HHS / United States
AI56933 / AI / NIAID NIH HHS / United States
AI69471 / AI / NIAID NIH HHS / United States
HL095126 / HL / NHLBI NIH HHS / United States
HL095132 / HL / NHLBI NIH HHS / United States
K24 AI056933 / AI / NIAID NIH HHS / United States
R01 HL095126 / HL / NHLBI NIH HHS / United States
R01 HL095132 / HL / NHLBI NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01 AI069471 / AI / NIAID NIH HHS / United States
U01AI068636 / AI / NIAID NIH HHS / United States
UM1 AI069432 / AI / NIAID NIH HHS / United States