title: [Clinical factors and biomarkers associated with subclinical atherosclerosis in the human immunodeficiency virus infection].
abstract: OBJECTIVE
  HIV-infected patients present accelerated cardiovascular disease (CVD) and CVD is among the most important causes of mortality in this population. We aimed to identify biomarkers and clinical factors associated with subclinical atherosclerosis in HIV-infected patients.
  
  
  METHODS
  Carotid intima-media thickness (cIMT) and cardiovascular biomarkers were measured in 235 HIV-infected patients. Individuals with a cIMT ≥ 75th percentile or plaque were classified as having subclinical atherosclerosis and compared with patients without subclinical atherosclerosis.
  
  
  RESULTS
  Age was 46 (11) years old. Mean cIMT was 0.58 (0.13)mm. Sixty-five (27.8%) patients had subclinical atherosclerosis. These subjects had more frequently lipodystrophy (OR:2.7; CI95%:1.4-4.9), immunosuppression (OR:2.5; CI95%:1.1-5.8), longer time to HIV diagnosis (≥ p50 [10 years], OR:1.4; CI95%:1.1-2.9), longer exposure to nucleoside analogues (≥ p50 [132 months], OR:3.2; CI95%:1.7-6) and to protease inhibitors (≥ p50 [24 months], OR:2.2; CI95%:1.1-3.6). They also showed higher levels of several biomarkers such as NT-proBNP (≥ p75 [72.6 pg/ml], OR:2.0; CI95%:1-4.1) and albumin/creatinine urine ratio (≥ p50 [5mg/g], OR:3.8; CI95%:1.3-11). After the multivariate analysis, subclinical atherosclerosis was associated with age (OR:6.6; CI95%:2.2-19.5; P=.001), a longer time to HIV diagnosis (OR:3.1; CI95%:1.0-11.0; P=.044) and immunosuppression (OR:2.8; CI95%:1-8.3; P=.048).
  
  
  CONCLUSIONS
  Among HIV-infected patients, time to HIV diagnosis and immunosuppression were independently associated with subclinical atherosclerosis. Patients with subclinical atherosclerosis showed increased levels of vascular damage biomarkers, especially albumin/creatinine urine ratio and NT-proBNP.
authors.affiliation: Servicio de Medicina Interna III, Hospital Clínico San Carlos, Madrid, España. serranovillar@gmail.com
authors.forename: Sergio
authors.initials: S
authors.lastname: Serrano-Villar
authors.forename: Vicente
authors.initials: V
authors.lastname: Estrada
authors.forename: Dulcenombre
authors.initials: D
authors.lastname: Gómez-Garre
authors.forename: Mario
authors.initials: M
authors.lastname: Ávila
authors.forename: Manuel
authors.initials: M
authors.lastname: Fuentes-Ferrer
authors.forename: Clara
authors.initials: C
authors.lastname: Sánchez-Parra
authors.forename: Talía
authors.initials: T
authors.lastname: Sainz
authors.forename: María
authors.initials: M
authors.lastname: de Carranza
authors.forename: Arturo
authors.initials: A
authors.lastname: Fernández-Cruz
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000378:metabolism; D015497:HIV-1; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine