期刊
AIDS
卷 27, 期 6, 页码 929-937出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0b013e32835ce27e
关键词
atherosclerosis; carotid arteries; endothelial function; HIV; inflammation
资金
- National Institute of Allergy and Infectious Diseases [U01AI068636]
- National Institute of Mental Health (NIMH)
- National Institute of Dental and Craniofacial Research (NIDCR)
- NIH from the National Heart, Lung, and Blood Institute [HL095132, HL095126, AI 068636, AI068634, AI69471, AI56933]
- National Institute of Allergy and Infectious Diseases
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. (c) 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins AIDS 2013, 27:929-937
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