Evaluation of cardiovascular risk factors in HIV-1 infected patients using carotid intima-media thickness measurement.
BACKGROUND
Highly active antiretroviral therapies (HAART) in HIV-infected patients are often associated with lipodystrophy syndrome and metabolic disorders. Atherogenic lipid profile could expose these patients to atheromatous cardiovascular disease. We describe carotid artery intima-media thickness (IMT), a surrogate marker of atherosclerosis, according to HIV status, antiretroviral treatment, lipodystrophy and conventional cardiovascular risk factors.


METHODS
In a multicenter prospective cohort study we have surveyed HIV-infected subjects with a carotid IMT measurement by B-mode ultrasonography. We collected information on lipodystrophy clinical manifestations, age, gender, body mass index (BMI), smoking habits, alcohol intake, systolic blood pressure, HIV transmission category, AIDS stage, type and duration of HAART, CD4+ cell count, plasma HIV-1 RNA, glucose, insulin, total cholesterol and homocysteine.


RESULTS
Four hundred and twenty-three HIV-infected patients were studied. The median carotid IMT measurement was 0.54 mm (range: 0.50-0.60). Lipodystrophy syndrome was diagnosed in 161 HIV-infected patients (38.1%). In univariate linear regression, IMT was significantly higher (P<0.05) with older age, male gender, higher body mass index, higher waist-to-hip ratio, increased systolic blood pressure, total cholesterol, glucose disorders and homocysteine, regular smoking and alcohol consumption, lipodystrophy and HAART. In a multivariate analysis, the effect of lipodystrophy and HAART disappeared after adjustment for other cardiovascular risk factors.


CONCLUSIONS
It was concluded that only conventional cardiovascular risk factors are independently associated with increased IMT in HIV-infected patients.
Mercié
Patrick
P
Service de Médecine Interne, Centre d'Information et de Soins de l'Immunodéfience Humaine, Centre Hospitalier Universitaire de Bordeaux, Pessac, France. patrick.mercie@chu-bordeaux.fr
Thiébaut
Rodolphe
R
Lavignolle
Valérie
V
Pellegrin
Jean-Luc
JL
Yvorra-Vives
Marie-Christine
MC
Morlat
Philippe
P
Ragnaud
Jean-Marie
JM
Dupon
Michel
M
Malvy
Denis
D
Bellet
Hélène
H
Lawson-Ayayi
Sylvie
S
Roudaut
Raymond
R
Dabis
Françios
F
D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D002339:Carotid Arteries; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D017539:Tunica Intima / Q000473:pathology*