Coronary artery calcium in HIV-infected men treated with highly active antiretroviral therapy.
Calcium is a common component of an atherosclerotic plaque; therefore, the presence of coronary artery calcium (CAC) indicates atherosclerosis. This study investigated the difference in total CAC scores between HIV-infected patients treated with highly active antiretroviral therapy (HAART) and HIV-negative age-matched controls. HIV patients were 27 men treated with a protease inhibitor-containing HAART regimen for more than 1 year (M = 4.92 years, SD = 2.02), aged 30 to 60 years (M = 43.52 years, SD = 6.65), and not receiving lipid-lowering or hypoglycemic drugs. Controls were age-matched men randomly selected (three controls to one case, for a total of 81 controls) from our existing database of 25,250 men who self-referred for CAC screening (control database). Electron beam tomography was used to obtain CAC scores. The CAC scores were coded as above or below the age-specific (stratified in 5-year increments) 10th, 25th, 50th, 75th, or 90th percentile of our control database. Chi-square analyses for two independent samples indicated (1) a larger frequency of controls with CAC scores above the 10th (chi1= 8.32, P = .004) and 25th (chi1= 5.45, P = .02) percentiles than that of HIV patients, (2) no differences in CAC scores between groups above the 50th (chi = 0.85, P = .357) or 75th (chi = 0.46, P = .497) percentile, and (3) a larger frequency of HIV patients who were above the 90th percentile (chi = 4.5, P = .034). The strength of the relationship between group membership and scoring above the 90th percentile was significant (phi = 0.20, P = .034). These results tentatively suggest that there is an elevated level of subclinical atherosclerosis in HIV patients treated with HAART.
Robinson
F Patrick
FP
College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA. prphd@uic.edu
Hoff
Julie Anne
JA
Kondos
George T
GT
D000328:Adult; D017677:Age Distribution; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002114:Calcinosis / Q000139:chemically induced* / Q000145:classification / Q000175:diagnosis; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000139:chemically induced* / Q000145:classification / Q000175:diagnosis; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects; D018023:HIV Seronegativity; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018401:Sample Size; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000592:standards
D017320:HIV Protease Inhibitors