Arterial stiffness evaluation in HIV-positive patients: a multicenter matched control study.
OBJECTIVE
The purpose of this article is to assess the differences, if any, in the values of carotid artery stiffness parameters between HIV-infected subjects without known cardiovascular disease (CVD) or carotid artery plaques and HIV-uninfected control subjects matched for sex, age, body mass index, and other CVD risk factors (i.e., hypertension, hypercholesterolemia, diabetes, and cigarette smoking). Arterial stiffness is emerging as a predictor of CVD risk. By recording the blood pressure, an automated echo-tracking system implemented in ultrasound equipment allows evaluation of arterial stiffness.


METHODS
Fifty-four HIV-infected patients without a history of CVD were closely matched for sex, age, body mass index, and CVD risk factors to 54 HIV-uninfected control subjects on an individual basis. Ultrasound studies of carotid artery stiffness parameters were performed using ultrasound equipment with a linear broadband high-frequency transducer. Carotid intima-media thickness was also measured. Repeatability between operators was assessed. Nonparametric Mann-Whitney U test, chi-square statistics, Fisher exact test, Pearson correlation coefficient, and intraclass correlation coefficient were used for statistical analysis. A p value less than 0.05 was considered statistically significant.


RESULTS
Except for arterial compliance in HIV-infected subjects, arterial stiffness parameters were correlated with age in both groups. Compared with matched control subjects, HIV-infected subjects showed lower arterial compliance parameter values (0.95 [interquartile range, 0.78-1.23] vs 0.76 [interquartile range, 0.62-1.00]; p = 0.0009), whereas other parameters were similar. Repeatability between operators was good.


CONCLUSIONS
HIV-infected subjects have an arterial compliance significantly lower than that of control subjects. The impairment of carotid artery distensibility may contribute to subclinical atherosclerosis.
Ultrasound Unit, Infectious Diseases Department, IRCCS Fondazione Policlinico San Matteo-University of Pavia, Italy. giovanna.ferraioli@unipv.it
Giovanna
G
Ferraioli
Carmine
C
Tinelli
Paolo
P
Maggi
Cristina
C
Gervasoni
Pierfrancesco
P
Grima
Klaudija
K
Viskovic
Scipione
S
Carerj
Gaetano
G
Filice
Carlo
C
Filice
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014463:Ultrasonography