title: Premature atherosclerosis in patients with acquired immunodeficiency syndrome.
abstract: BACKGROUND
  Increased risk of atherosclerosis has been reported in patients with human immunodeficiency virus (HIV) infection since highly active antiretroviral therapy (HAART) has come into use. However, there is no clear evidence of premature atherosclerosis in Chinese HIV-infected patients. Our study was designed to determine the relationship between HIV infection and atherosclerosis in Chinese HIV-infected patients.
  
  
  METHODS
  One hundred and forty-five patients were enrolled in this study. These included 82 HIV-infected patients (41 HAART-treated and 41 antiretroviral therapy (ART) naïve patients) and 43 HIV-negative control subjects. Data on traditional cardiovascular risk factors, HIV infection parameters, and treatment regimens were collected. Pulse wave velocity (PWV) was determined using a pulse pressure analyzer to evaluate the function of the arterial wall as an indicator of atherosclerotic vascular damage.
  
  
  RESULTS
  A higher PWV ((1358.3 ± 117.8) cm/s vs. (1270.2 ± 189.2) cm/s, P = 0.010) was found in ART naïve HIV-infected patients compared with control subjects. However, HAART treated patients had lower PWV compared to ART naïve patients ((1283.8 ± 181.4) cm/s vs. (1358.0 ± 117.8) cm/s, P = 0.033). Multiple regression analysis revealed that age (B = 5.218, 95% confidence interval (CI) 1.420 - 9.016, P = 0.008), current smoking (B = -74.671, 95%CI -147.003 to -2.339, P = 0.043) and HAART (92.7% patients on a protease inhibitor-free regimen) (B = -169.169, 95%CI -272.508 to -65.831, P = 0.010) were associated with reduced PWV in HIV-infected patients.
  
  
  CONCLUSIONS
  Reduced PWV in HIV-infected Chinese patients indicates that they are more likely to develop arterial wall stiffness, possibly by atherosclerosis. A protease inhibitor-free regime may be protective for arterial wall of HIV infected patients.
authors.affiliation: Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zeng
authors.forename: Yi-Cong
authors.initials: YC
authors.lastname: Ye
authors.forename: Ling
authors.initials: L
authors.lastname: Luo
authors.forename: Zhi-Feng
authors.initials: ZF
authors.lastname: Qiu
authors.forename: Yang
authors.initials: Y
authors.lastname: Han
authors.forename: Xiao-Meng
authors.initials: XM
authors.lastname: Li
authors.forename: Quan
authors.initials: Q
authors.lastname: Fang
authors.forename: Shu-Yang
authors.initials: SY
authors.lastname: Zhang
authors.forename: Tai-Sheng
authors.initials: TS
authors.lastname: Li
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D050197:Atherosclerosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D012044:Regression Analysis; D059289:Vascular Stiffness