Human immunodeficiency virus 1 infection, cocaine, and coronary calcification.
BACKGROUND
Although cocaine use and human immunodeficiency virus (HIV) infection have been linked with clinical cardiovascular disease, the effects of cocaine use and HIV infection, especially the combination of the 2, on subclinical disease have rarely been reported. The objective of this study was to evaluate whether cocaine use alone, HIV infection alone, or a combination of the 2 is associated with coronary calcification, a marker of subclinical atherosclerosis.


METHODS
Between May 20, 2000, and March 31, 2003, 224 black study participants from Baltimore were enrolled in an observational study of subclinical atherosclerosis as related to HIV and cocaine use. Interviews about sociodemographic characteristics and drug use behaviors, clinical examinations, echocardiographic examinations, lipid profiles, high-sensitivity C-reactive protein tests, and computed tomographic scans for coronary calcium were performed. Although the overall investigation is a cohort study, the data presented herein are cross sectional only.


RESULTS
The highest proportion (37.6%) of presence of coronary calcification was in the HIV-positive and cocaine-positive group, followed by 29.8% in the HIV-negative and cocaine-positive group, 28.6% in the HIV-positive and cocaine-negative group, and 18.8% in the HIV-negative and cocaine-negative group. Univariate analysis showed that HIV, cocaine use, and both were associated with a higher number of lesions, calcified area, volume, and calcium score. In multiple regression analysis with adjustment for age, body mass index, low-density lipoprotein cholesterol level, triglyceride level, mean corpuscular volume, and systolic blood pressure, HIV, cocaine use, and both were independently associated with coronary calcification.


CONCLUSIONS
These results suggest that HIV infection alone, cocaine use alone, or the 2 combined may contribute to early subclinical atherosclerotic cardiovascular disease.
Lai
Shenghan
S
Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA. slai@jhmi.edu
Lima
Joao A C
JA
Lai
Hong
H
Vlahov
David
D
Celentano
David
D
Tong
Wenjing
W
Bartlett
John G
JG
Margolick
Joseph
J
Fishman
Elliot K
EK
D000328:Adult; D000704:Analysis of Variance; D015142:Baltimore / Q000453:epidemiology; D044383:Black People; D002114:Calcinosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D016009:Chi-Square Distribution; D019970:Cocaine-Related Disorders / Q000150:complications*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D001741:Black or African American