Predictive factors of vascular intima media thickness in HIV-positive subjects.
BACKGROUND
The predictive factors of intima media thickness (IMT) in the HIV-infected population are still poorly understood.


METHODS
We studied three groups of subjects, aged 30-50 years, to find potential predictive factors of carotid and/or femoral thickening (IMT > 1 mm in at least one area): healthy controls (G1, n = 54), HIV-infected naive (G2, n = 53) and highly active antiretroviral treatment (HAART)-treated subjects (G3, n = 133). All the subjects underwent ultrasonography of the carotid and femoral vessels to evaluate IMT.


RESULTS
Demographic characteristics of the three groups were comparable, except for gender (G1 had a higher percentage of females) and lipid levels (higher in G3). A total of 115 subjects (47.9%) had carotid and/or femoral IMT: 26 in G1 (48.1%), 21 in G2 (39.6%) and 68 in G3 (51.1%). Independent predictive factors of carotid and/or femoral IMT were older age (OR: 2.81, 95% CI: 1.95-4.04, P < 0.01, for each additional 5 years), triglycerides >or=150 mg/dL (OR: 2.66, 95% CI: 1.27-5.57, P < 0.001), serum glucose >or=110 mg/dL (OR: 5.24, 95% CI: 1.02-27.05, P = 0.04), high homocysteinaemia (OR: 2.75, 95% CI: 1.17-6.46, P = 0.02) and high body mass index (OR: 1.10, 95% CI: 1-1.22, P = 0.05 for each additional unit); females had a lower risk (OR: 0.38, 95% CI: 0.18-0.79, P < 0.01 versus males). HAART use was not associated with IMT (OR: 0.64, 95% CI: 0.27-1.53, P = 0.32 and OR: 0.80, 95% CI: 0.30-2.13, P = 0.20 for G3 and G2 versus G1, respectively).


CONCLUSIONS
This study demonstrates that traditional risk factors for cardiovascular diseases overshadow the role of HAART in determining premature vascular lesions.
Bongiovanni
M
M
Department of Medicine, Surgery and Dentistry, Institute of Infectious Diseases and Tropical Medicine, San Paolo Hospital, University of Milan, Via di Rudinì 8, 20142 Milan, Italy. marco.bongiovanni@unimi.it
Casana
M
M
Cicconi
P
P
Pisacreta
M
M
Codemo
R
R
Pelucchi
M
M
d'Arminio Monforte
A
A
Bini
T
T
D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002318:Cardiovascular Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D018615:Ultrasonography, Doppler, Color
D019380:Anti-HIV Agents; D008055:Lipids