Progression of carotid intima-media thickness and coronary artery calcium over 6 years in an HIV-infected cohort.
OBJECTIVE
To evaluate changes in cardiovascular disease risk surrogate markers in a longitudinal cohort of HIV-infected adults over 6 years.


METHODS
Internal carotid artery (ICA) and common carotid artery (CCA) intima-media thickness (IMT), coronary artery calcium (CAC), vascular, and HIV risk factors were prospectively examined over 6 years in HIV-infected adults from 2002 to 2010.


METHODS
Longitudinal cohort study with participants from urban center and surrounding communities.


METHODS
Three hundred forty-five HIV-infected participants were recruited from a longitudinal cohort study. Two hundred eleven participants completed the study and were included in this analysis.


METHODS
Total and yearly ICA and CCA IMT change; CAC score progression.


RESULTS
Participants were 27% female and 49% nonwhite; mean age at start was 45 ± 7 years. The median change in ICA and CCA over 6 years was 0.15 mm (0.08, 0.28) and 0.12 mm (0.09, 0.15), respectively. Age, baseline triglycerides ≥150 mg/dL, and pack-years smoking were associated with ICA IMT change; age, cholesterol, nadir CD4 count, and protease inhibitor use were associated with CCA IMT change. Diabetes, HIV viral load, and highly active antiretroviral therapy duration were associated with CAC progression.


CONCLUSIONS
Carotid IMT and CAC progressed in this HIV-infected cohort. Some HIV-specific characteristics were associated with surrogate marker changes, but the majority of risk factors continue to be traditional. Aggressive identification and management of modifiable risk factors may reduce progression of cardiovascular disease risk in this population.
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA. gvolpe@tuftsmedicalcenter.org
Gretchen E
GE
Volpe
Alice M
AM
Tang
Joseph F
JF
Polak
Alexandra
A
Mangili
Sally C
SC
Skinner
Christine A
CA
Wanke
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D018791:CD4 Lymphocyte Count; D002118:Calcium / Q000378:metabolism; D002340:Carotid Artery Diseases / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011480:Protease Inhibitors / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014481:United States / Q000453:epidemiology; D014505:Urban Population
D015415:Biomarkers; D001786:Blood Glucose; D011480:Protease Inhibitors; D002097:C-Reactive Protein; D002118:Calcium