title: Carotid artery intima-media thickness and HIV infection: traditional risk factors overshadow impact of protease inhibitor exposure.
abstract: BACKGROUND
  The impact of HIV infection and exposure to antiretroviral therapy on the development of subclinical atherosclerosis is incompletely understood.
  
  
  OBJECTIVE
  To compare intima-media thickness (IMT) of the carotid artery between HIV-infected subjects receiving protease inhibitor-containing regimens and subjects not receiving these regimens and to compare differences in the IMT of the carotid artery between HIV-infected subjects and HIV-uninfected subjects.
  
  
  METHODS
  A prospective matched cohort study in university-based outpatient clinics. Groups of three individuals (triads) matched on the following characteristics were enrolled: age, sex, race/ethnicity, smoking status, blood pressure and menopausal status. Group 1, HIV-infected subjects with continuous use of protease inhibitor (PI) therapy for > or = 2 years; group 2, HIV-infected subjects without prior PI use; and group 3: HIV-uninfected. Ultrasonographers at six sites sent standardized ultrasound images to a central reading site for carotid IMT measurements. Carotid IMT was compared within the HIV-infected groups (1 and 2) and between the HIV-infected and uninfected groups in a matched analysis.
  
  
  RESULTS
  One hundred and thirty-four individuals were enrolled in 45 triads. The median IMT in groups 1, 2 and 3 was 0.690, 0.712 and 0.698 mm, respectively. There were no statistically significant differences in IMT between groups 1 and 2, or in the combined HIV groups compared with the HIV uninfected group. Significant predictors of carotid IMT in a multivariate model included high-density lipoprotein (HDL) cholesterol, the interaction of HDL cholesterol and triglycerides, age and body mass index.
  
  
  CONCLUSIONS
  We found no association between PI inhibitor exposure or HIV infection and carotid IMT.
authors.affiliation: Center for Clinical AIDS Research and Education, Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA 90095, USA. jscurrier@mednet.ucla.edu
authors.forename: Judith S
authors.initials: JS
authors.lastname: Currier
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Kendall
authors.forename: Robert
authors.initials: R
authors.lastname: Zackin
authors.forename: W Keith
authors.initials: WK
authors.lastname: Henry
authors.forename: Beverly
authors.initials: B
authors.lastname: Alston-Smith
authors.forename: Francesca J
authors.initials: FJ
authors.lastname: Torriani
authors.forename: Jeff
authors.initials: J
authors.lastname: Schouten
authors.forename: Keith
authors.initials: K
authors.lastname: Mickelberg
authors.forename: Yanjie
authors.initials: Y
authors.lastname: Li
authors.forename: Howard N
authors.initials: HN
authors.lastname: Hodis
mesh_terms: D000328:Adult; D000886:Anthropometry; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D008076:Cholesterol, HDL / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D014463:Ultrasonography
chemical_list: D008076:Cholesterol, HDL; D017320:HIV Protease Inhibitors; D014280:Triglycerides