Journal
AIDS
Volume 23, Issue 14, Pages 1841-1849Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0b013e32832d3b85
Keywords
atherosclerosis; carotid intima-medial thickness; cholesterol; diabetes; HIV; smoking
Categories
Funding
- NCRR NIH HHS [M01-RR0636, M01-RR00036, M01-RR00083, M01-RR00051, M01 RR000051, M01-RR00865, M01 RR000083, M01-RR00052, M01-RR00054, M01 RR000036, M01 RR000865, UL1-RR024131, M01 RR000052, M01 RR000054, UL1 RR024131] Funding Source: Medline
- NHLBI NIH HHS [R01 HL074814, N01-HC-95160, N01-HC-95159, R01-HL 53359, N01-HC-95162, N01-HC-95161, N01-HC-95165, R01 HL074814-06, R01 HL074814-04, N01HC95169, N01-HC-95163, R01 HL074814-07, N01HC95165, N01-HC-95164, N01HC95159, R01-HL74814, R01 HL074814-05] Funding Source: Medline
- NIAID NIH HHS [K23 AI066943-05, K23 AI066943, K24 AI056933, K24-AI56933] Funding Source: Medline
- NIDDK NIH HHS [R01 DK057508-01S1, R01 DK057508, R01 DK057508-03, R01-DK57508, R01 DK057508-03S1, R01 DK057508-02, R01 DK057508-03S2, R01 DK057508-01] Funding Source: Medline
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Background: Cardiovascular disease (CVD) is an increasing cause of morbidity and mortality in HIV-infected patients. However, it is controversial whether HIV infection contributes to accelerated atherosclerosis independent of traditional CVD risk factors. Methods: Cross-sectional Study of HIV-infected participants and controls without preexisting CVD from the study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM) and the Multi-Ethnic Study of Atherosclerosis (MESA). Preclinical atherosclerosis was assessed by carotid intima-medial thickness (cIMT) measurements in the internal/bulb and common regions in HIV-infected participants and controls after adjusting for traditional CVD risk factors. Results: For internal carotid, mean IMT was 1.17 +/- 0.50 mm for HIV-infected participants and 1.06 +/- 0.58 mm for controls (P<0.0001). After multivariable adjustment for demographic characteristics, the mean difference of HIV-infected participants vs. controls was 0.188 mm [95%, confidence interval (CI) 0.113-0.263, P<0.0001]. Further adjustment for traditional CVD risk factors modestly attenuated the HIV association (0.148 mm, 95% CI 0.072-0.224, P=0.0001). For the common carotid, HIV infection was independently associated with greater IMT (0.033 mm, 95% Cl 0.010-0.056, P=0.005). The association of HIV infection with IMT was similar to that of smoking, which was also associated with greater IMT (internal 0.173 mm, common 0.020 mm). Conclusion: Even after adjustment for traditional CVD risk factors, HIV infection was accompanied by more extensive atherosclerosis measured by IMT. The stronger association of HIV infection with IMT in the internal/bulb region compared with the common carotid may explain previous discrepancies in the literature. The association of HIV infection with IMT was similar to that of traditional CVD risk factors, such as smoking. (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
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