title: [Effect of antiretroviral therapy on carotid intima-media thickness in HIV-infected patients].
abstract: BACKGROUND
  The introduction of highly active antiretroviral therapy reduced HIV-associated morbidity and mortality, at the cost of adverse metabolic effects that increase cardiovascular risk. The aim of this study was to evaluate the impact of exposure to protease inhibitors (PI) compared with exposure to non-nucleoside reverse transcriptase inhibitors (NNRTI) on carotid intima-media thickness (IMT) and blood flow velocity and to measure vascular involvement over a 2-year follow-up in HIV-infected patients treated with PI.
  
  
  METHODS
  Thirty-five HIV-infected patients treated with PI (group I) and 15 patients treated with NNRTI (group II) underwent epiaortic vessel ultrasonography. The same evaluation was obtained in a group of 20 healthy subjects. After 20 +/- 2 months, 22 patients of group I were re-evaluated and the follow-up data were compared with those obtained at baseline.
  
  
  RESULTS
  The ANOVA test showed a significant difference among the three groups for IMT and flow velocities. Bonferroni analyses showed significant differences in IMT and flow velocities in group I vs group II vs controls: IMT of the right common carotid artery was 0.742 +/- 0.135 mm in group I vs 0.642 +/- 0.131 mm in group II (p < 0.05) and 0.616 +/- 0.069 mm in controls (p = 0.002); IMT of left common carotid artery was 0.720 +/- 0.108 vs 0.659 +/- 0.066 mm (p < 0.05) and 0.640 +/- 0.081 mm (p < 0.01), respectively. There were no differences in group II vs healthy subjects. At follow-up examinations of group I, no significant differences were observed in both IMT and blood flow velocity when compared with baseline values.
  
  
  CONCLUSIONS
  The HIV-infected patients treated with PI show earlier vascular involvement as compared to those treated with NNRTI and to healthy subjects with similar distribution of cardiovascular risk factors. However, such damage seems to have no significant progression over a 2-year follow-up in HIV-infected patients treated with PI. These data emphasize the need for follow-up studies assessing whether these changes are predictive of adverse cardiac events.
authors.affiliation: U.O.C. di Cardiologia, Ospedale D. Cotugno, Napoli. srg.ferraro@virgilio.it
authors.forename: Sergio
authors.initials: S
authors.lastname: Ferraro
authors.forename: Stefania
authors.initials: S
authors.lastname: Paolillo
authors.forename: Miriam
authors.initials: M
authors.lastname: Gargiulo
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Costanzo
authors.forename: Paolo
authors.initials: P
authors.lastname: Maggi
authors.forename: Antonio
authors.initials: A
authors.lastname: Chirianni
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiariello
authors.forename: Pasquale Perrone
authors.initials: PP
authors.lastname: Filardi
mesh_terms: D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000187:drug effects* / Q000473:pathology*; D005260:Female; D017320:HIV Protease Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D054303:HIV Reverse Transcriptase / Q000037:antagonists & inhibitors*; D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000187:drug effects* / Q000473:pathology*; D017540:Tunica Media / Q000187:drug effects* / Q000473:pathology*
chemical_list: D017320:HIV Protease Inhibitors; D054303:HIV Reverse Transcriptase