Cardiovascular risk factors and probability for cardiovascular events in HIV-infected patients: part I. Differences due to the acquisition of HIV-infection.
OBJECTIVE
Due to side effects, such as hyperlipidaemia and insulin resistance, there is an increasing concern that antiretroviral drugs lead to an epidemic of cardiovascular diseases in HIV-infected patients. The present study characterizes the cardiovascular risk profile of HIV-infected individuals, due to the acquisition of HIV-infection.


METHODS
Cardiovascular risk factors of 309 HIV-infected adults (HIV-acquisition: 59.2% by homosexual contact (group 1), 28.5% by heterosexual contact (group 2), 9.1% by intravenous drug abuse (group 3) and 3.2% by blood transfusion (group 4)) were analysed. Overall 10-years probability for cardiovascular events was analysed by the Framingham algorithm.


RESULTS
Tobacco use was more common in group 1 subjects compared with group 2 subjects (67% vs. 52%; p<0.05). Additionally, group 1 subjects exhibited elevated total cholesterol (5.6 +/- 0.1 mmol/L vs. 4.8 +/- 0.3), LDL-cholesterol (3.6 +/- 0.1 mmol/L vs. 2.8 +/- 0.2) and triglyceride concentrations (3.2 +/- 0.3 mmol/L vs. 1.7 +/- 0.2) compared with group 3 (all p<0.05). No significant differences between the groups were detected in glucose metabolism. The overall 10-years probability for cardiovascular events was significantly higher in group 1 compared with group 2 and group 3 (12.2 +/- 0.8% vs. 6.6 +/- 0.9% and 7.9 +/- 1.6%, p<0.05).


CONCLUSIONS
The cardiovascular risk profile differs between subgroups of HIV-infected individuals, leading to significant higher probability of cardiovascular events in group 1 subjects. The risk of premature atherosclerosis by HIV-infected individuals and therapeutic options remains to be established.
Neumann
T
T
Department of Cardiology, University of Essen, Medical School, Hufelandstr. 55, D-45122 Essen, Germany. till.neumann@uni-essen.de
Woiwoid
T
T
Neumann
A
A
Miller
M
M
Ross
B
B
Volbracht
L
L
Brockmeyer
N
N
Gerken
G
G
Erbel
R
R
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002318:Cardiovascular Diseases / Q000209:etiology*; D002784:Cholesterol / Q000097:blood; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D012307:Risk Factors; D012907:Smoking; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D002784:Cholesterol