B-mode ultrasound study of carotid plaques in HIV-positive patients to detect the presence of inflammatory endothelial lesions.
Several reports have indicated that patients with low CD4+ cell count could be at a higher risk for arterial lesions or cardiovascular disease (CVD). Recently, current use of abacavir has been associated with an excess risk of CVD. High sensitivity-C-reactive protein and interleukin-6 levels were high for patients receiving the drug. These data lead to the hypothesis that alternative mechanisms may be at work other that those linked to lipid changes and "classic" risk factors for atheroma. Consequently, we investigated the ultrasound characteristics of carotid plaques in HIV-positive patients comparing the results with those obtained from patients affected by atherosclerosis and patients with arteritis. The study population included 110 HIV-positive patients and 91 HIV-negative patients (61 atherosclerotic patients and 30 with arteritis). All patients were subjected to ultrasonography of the epi-aortic vessels. When compared to atherosclerotic patients, there was a significantly higher proportion of HIV-positive patients with hypoechogenic and homogeneous lesions, uniform in their parietal and endoluminal portions with a smooth or slightly irregular surface. No significant differences were found between HIV-positive and arteritis patients. This ultrasonographic study confirms that inflammatory mechanisms could play a major role in the onset of vascular damage in HIV-1 positive patients.
Maggi
Paolo
P
Institute of Infectious Diseases and Chair of Vascular Surgery, University of Bari, Italy. p_maggi@yahoo.com
Perilli
Francesco
F
Lillo
Antonio
A
Volpe
Anna
A
Pastore
Giuseppe
G
Regina
Guido
G
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D001167:Arteritis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D000099227:Abacavir
D019380:Anti-HIV Agents; D002097:C-Reactive Protein; D015224:Dideoxynucleosides; D015850:Interleukin-6; D000099227:Abacavir