title: Progression of coronary artery calcium in men affected by human immunodeficiency virus infection.
abstract: Cardiovascular risk is increased in HIV infected patients. We assessed progression of coronary artery calcium (CAC) in patients with HIV infection to identify factors that may help explain progression of atherosclerosis. Prospective, observational study of 132 HIV-infected men receiving chronic antiretroviral therapy (ART); we measured traditional atherosclerosis risk factors and assessed progression of CAC on sequential 64-slice CT scans at an average interval of 11 months (range 6-36). CAC score progression was defined as absolute and percentage change from baseline. During follow-up 45 patients (34%) showed absolute progression of CAC and 34 of them showed >15% yearly progression, a threshold previously associated with a high risk of myocardial infarction. Age, LDL cholesterol, visceral abdominal fat and current T-helper (CD4+) cell count were significantly associated with absolute CAC progression. Progression of subclinical atherosclerosis in HIV patients is associated with traditional coronary risk factors as well as HIV related factors such as the CD4+ cell count. Therefore, immunologic perturbations secondary to HIV infection may contribute to atherosclerosis progression.
authors.affiliation: Metabolic Clinic, Infectious and Tropical Diseases Unit, Department of Medicine, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Stefano
authors.initials: S
authors.lastname: Zona
authors.forename: Gabriella
authors.initials: G
authors.lastname: Orlando
authors.forename: Federica
authors.initials: F
authors.lastname: Carli
authors.forename: Guido
authors.initials: G
authors.lastname: Ligabue
authors.forename: Federica
authors.initials: F
authors.lastname: Fiocchi
authors.forename: Rosario
authors.initials: R
authors.lastname: Rossi
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Modena
authors.forename: Paolo
authors.initials: P
authors.lastname: Raggi
mesh_terms: D050154:Adiposity; D000328:Adult; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers / Q000097:blood; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000821:virology; D018450:Disease Progression; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000209:etiology* / Q000821:virology
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL