Carotid intima-media thickness and arterial stiffness in HIV-infected patients: the role of HIV, antiretroviral therapy, and lipodystrophy.
OBJECTIVE
HIV-infected patients using combination antiretroviral therapy (ART) have an increased cardiovascular risk. We aimed to identify the effects of HIV, ART, and lipodystrophy (LD) on carotid artery intima-media thickness (C-IMT), a surrogate measure of atherosclerosis, and arterial stiffness, a marker of cardiovascular risk.


METHODS
Case-control study of 77 HIV-infected men (55 exposed to ART, 22 ART naive, and 23 with LD) and 52 controls.


METHODS
C-IMT was measured ultrasonically, and arterial stiffness was estimated by distensibility (DC) and compliance (CC) coefficients of the carotid, femoral, and brachial arteries, by the carotid Young elastic modulus and pulse wave velocity.


RESULTS
After adjustment for cardiovascular risk factors, HIV-infected patients had a 0.067 mm (10.8%) greater C-IMT than controls, 13.6% and 29.5% lower DC, and 14.1% and 31% lower CC of the carotid and femoral arteries, respectively, but similar Young elastic modulus and pulse wave velocity. Patients exposed to ART had similar C-IMT compared with ART-naive patients but 25.9% lower DC and 21.7% lower CC of the femoral artery. Arterial properties did not differ between patients with and without LD.


CONCLUSIONS
HIV infection is independently associated with C-IMT and generally increased arterial stiffness. ART use is associated with increased stiffness of the femoral artery.
van Vonderen
Marit G A
MG
Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands. m.van.vonderen@znb.nl
Smulders
Yvo M
YM
Stehouwer
Coen D A
CD
Danner
Sven A
SA
Gundy
Chad M
CM
Vos
Frieda
F
Reiss
Peter
P
Agtmael
Michiel A van
MA
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D055119:Elastic Modulus; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1 / Q000472:pathogenicity*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014463:Ultrasonography
D019380:Anti-HIV Agents