Progression of carotid artery intima-media thickening in HIV-infected and uninfected adults.
OBJECTIVE
To compare the rate of change in intima-media thickness (IMT) of the carotid artery among uninfected subjects and HIV-infected subjects receiving or not receiving protease inhibitor (PI) regimens over a 144 week period.


METHODS
This prospective, matched cohort study enrolled 133 subjects into 45 triads (groups of three subjects matched by age, sex, race/ethnicity, smoking status, blood pressure, and menopause) from university based outpatient HIV clinics. Each triad consisted of one subject from each of the following groups: 1, HIV-infected subjects with continuous use of PI therapy for > or = 2 years; 2, HIV-infected subjects without prior PI use; 3, HIV-uninfected subjects.


METHODS
Standardized ultrasound images of carotid IMT were collected at weeks 0, 2, 24, 48, 72, 96, and 144. The main outcome was the yearly progression rate of carotid IMT (mm/year).


RESULTS
The median yearly IMT progression rate in groups 1, 2, and 3 was 0.0096, 0.0058, and 0.0085 mm/year, respectively. There were no statistically significant differences in progression between groups 1 and 2, or between the combined HIV-positive groups and the HIV-negative control group. A multicovariate model examining predictors of progression in carotid IMT among all subjects contained low density lipoprotein cholesterol and homocysteine. Among HIV subjects, predictors included nadir CD4 cell count and ritonavir use.


CONCLUSIONS
HIV infection and PI use did not contribute substantially to the rate of carotid IMT progression in our matched study.
Currier
Judith S
JS
Center for Clinical AIDS Research and Education, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA. jscurrier@mednet.ucla.edu
Kendall
Michelle A
MA
Henry
W Keith
WK
Alston-Smith
Beverly
B
Torriani
Francesca J
FJ
Tebas
Pablo
P
Li
Yanjie
Y
Hodis
Howard N
HN
D000328:Adult; D018791:CD4 Lymphocyte Count; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000378:metabolism / Q000473:pathology; D011446:Prospective Studies; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D017320:HIV Protease Inhibitors; D000960:Hypolipidemic Agents; D002784:Cholesterol