title: [Asymptomatic peripheral arterial disease detected by the ankle-brachial index in HIV-infected patients: prevalence and associated risk factors].
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) infection has been associated with a higher risk of subclinical atherosclerosis and cardiovascular events. Peripheral arterial disease (PAD) is a good marker of systemic atherosclerosis and a powerful predictor of cardiovascular morbidity and mortality. The objective of this study was to determine the prevalence of asymptomatic PAD and associated risk factors in HIV-infected people.
  
  
  METHODS
  Cross-sectional study was conducted on all consecutive HIV-positive patients older than 20 years without symptoms of intermittent claudication who attended our clinic between November 2008 and December 2009. PAD was assessed by measuring the ankle-brachial index (ABI) at rest. To define PAD, an ABI ≤ 0.90 was used. Main epidemiological and clinical characteristics of the HIV infection and cardiovascular risk factors (CVRF) were recorded.
  
  
  RESULTS
  Two hundred and five patients were evaluated (66.8% male), with a mean age of 41 years and there was a median of 2 CVRF (63.9% smokers). Prevalence of asymptomatic PAD (ABI ≤ 0.90) was 6.3% (n=13). There was only 1 patient with a high ABI (>1.40). In the multivariate analysis, factors significantly associated with PAD were overweight (adjusted odds ratio [ORadj] 4.21; 95% confidence interval [CI] 1.00-18.78), obesity (ORadj 5.76; 95% CI 1.17-28.37) and clinical stage C of HIV infection (ORadj 2.95; 95% CI 1.00-9.83).
  
  
  CONCLUSIONS
  Prevalence of asymptomatic PAD in a relatively young HIV-infected cohort is similar to that observed in the uninfected middle-aged adult population. Overweight, obesity and advanced clinical stage of HIV infection (AIDS-defining conditions) were identified as independent risk factors for PAD.
authors: Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España. ecanalejo@gmail.com
authors: Eduardo
authors: E
authors: Canalejo
authors: Noemí
authors: N
authors: Cabello
authors: Isabel
authors: I
authors: Perales
authors: Sonia
authors: S
authors: Allodi
authors: Aquilino
authors: A
authors: Sánchez-Purificación
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001161:Arteriosclerosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006525:Hepatitis, Viral, Human / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D014463:Ultrasonography; D055815:Young Adult