An ultrasound-based comparative study on carotid plaques in HIV-positive patients vs. atherosclerotic and arteritis patients: atherosclerotic or inflammatory lesions?
BACKGROUND
We have previously described two cases of HIV-1-positive patients undergoing surgery for stenosis of the internal carotid arteries. Histology revealed an extensive inflammatory infiltration of the vascular wall and no evidence of atheromasic plaque. This unexpected pattern of carotid damage prompted us to perform a more accurate investigation of the characteristics of carotid plaques in a group of HIV-positive patients. The results were compared with those obtained from young patients affected by atherosclerosis of the epi-aortic vessels and patients with arteritis.


METHODS
The patients underwent ultrasonography of the epi-aortic vessels using one of the latest generation power color-Doppler with 7.5 MHz probes.


RESULTS
The study population included 61 HIV-positive patients and 47 HIV-negative patients (37 atherosclerotic and 10 with arteritis). Compared with HIV-negative atherosclerotic patients, there were significantly higher proportions of HIV-positive patients with iso-hypoechogenic lesions (81.8 vs. 29%) that were homogeneous both in their parietal and endoluminal portions (96.7 vs. 21.6% and 88.5 vs. 54.0%, respectively), with a smooth or slightly irregular surface (99.0 vs. 56.7%) (P=0.001 for all differences). No statistically significant differences were seen between HIV-positive and arteritis patients.


CONCLUSIONS
Our study evidenced that the ultrasonographic structure of the epi-aortic lesions in HIV-positive patients substantially differ from those of the plaques in atherosclerotic patients, although they share similar characteristics with patients affected by arteritis. Further investigations are warranted to better define the structure and the mechanism of onset of these lesions.
Maggi
Paolo
P
Institute of Infectious Diseases, University of Bari, Bari, Italy. p_maggi@yahoo.com
Perilli
Francesco
F
Lillo
Antonio
A
Carito
Valentina
V
Epifani
Giuseppe
G
Bellacosa
Chiara
C
Pastore
Giuseppe
G
Regina
Guido
G
D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging; D001167:Arteritis / Q000150:complications* / Q000000981:diagnostic imaging; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015497:HIV-1 / Q000187:drug effects / Q000276:immunology*; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014463:Ultrasonography
D017320:HIV Protease Inhibitors