Journal
HIV MEDICINE
Volume 11, Issue 4, Pages 225-231Publisher
WILEY
DOI: 10.1111/j.1468-1293.2009.00766.x
Keywords
cardiovascular disease; inflammation; lipoproteins; risk factors
Categories
Funding
- Red de Centros de Metabolismo y Nutricion (RCMN) [C03/08]
- Fondo de Investigacion Sanitaria (FIS) of the Instituto de Salud Carlos III, Madrid, Spain [04/1752, 05/1607, 08/1175, CM06/00246]
- Generalitat de Catalunya [FI 06/01054, 08/00064, 05SGR 00503]
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Objectives HIV-infected patients show an increased cardiovascular disease (CVD) risk resulting, essentially, from metabolic disturbances related to chronic infection and antiretroviral treatments. The aims of this study were: (1) to evaluate the agreement between the CVD risk estimated using the Framingham risk score (FRS) and the observed presence of subclinical atherosclerosis in HIV-infected patients; (2) to investigate the relationships between CVD and plasma biomarkers of oxidation and inflammation. Methods Atherosclerosis was evaluated in 187 HIV-infected patients by measuring the carotid intima-media thickness (CIMT). CVD risk was estimated using the FRS. We also measured the circulating levels of interleukin-6, monocyte chemoattractant protein-1 (MCP-1) and oxidized low-density lipoprotein (LDL), and paraoxonase-1 activity and concentration. Results There was a weak, albeit statistically significant, agreement between FRS and CIMT (kappa=0.229, P < 0.001). A high proportion of patients with an estimated low risk had subclinical atherosclerosis (n=66; 56.4%). In a multivariate analysis, the presence of subclinical atherosclerosis in this subgroup of patients was associated with age [odds ratio (OR) 1.285; 95% confidence interval (CI) 1.084-1.524; P=0.004], body mass index (OR 0.799; 95% CI 0.642-0.994; P=0.044), MCP-1 (OR 1.027; 95% CI 1.004-1.050; P=0.020) and oxidized LDL (OR 1.026; 95% CI 1.001-1.051; P=0.041). Conclusion FRS underestimated the presence of subclinical atherosclerosis in HIV-infected patients. The increased CVD risk was related, in part, to the chronic oxidative stress and inflammatory status associated with this patient population.
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