title: Early atherosclerosis in HIV-infected patients below the age of 55 years: Slovenian national study.
abstract: BACKGROUND
  Increased life expectancy of human immunodeficiency virus (HIV)-infected patients appears to be coupled with increased incidence of cardiovascular disease (CVD).
  
  
  OBJECTIVE
  The aim of our study was to determine the presence of early atherosclerosis among Slovenian HIV-infected patients below the age of 55 years.
  
  
  METHODS
  A total of 86 HIV-infected male patients below the age of 55 years participated in our study. Ankle-brachial index (ABI) was measured using a handheld Doppler ultrasonic probe and a blood pressure cuff. Carotid intima-media thickness (CIMT) was assessed by the B-mode high-resolution ultrasound technique. Low ABI, CIMT > 0.8 mm or presence of carotid plaques were considered markers of early atherosclerosis.
  
  
  RESULTS
  Average CIMT was lowest among treatment-naïve patients (0.65 mm); 10 (38.4 %) had CIMT > 0.8 mm, and carotid plaques were detected in 1 (3.8 %). Average CIMT among treated patients was 0.71 mm; 30 (50.0 %) had CIMT > 0.8 mm, and plaques were detected in 11 (18.3 %). Low ABI (≤ 0.90) was found in five patients (5.8 %) without symptoms of peripheral artery disease; two were treatment-naïve, and three received antiretroviral therapy. Early atherosclerosis was found in 43 (50.0 %) patients; 10 (38.4 %) were in treatment-naïve and 33 (55.0 %) in the treated group.
  
  
  CONCLUSIONS
  Increased prevalence of early atherosclerosis among Slovenian HIV-infected patients below the age of 55 years has been demonstrated. Screening for early atherosclerosis should be implemented in the evaluation of young HIV-infected patients because a more aggressive treatment approach, aimed to delay the progression of atherosclerosis, may be warranted especially when carotid plaques are detected. We have shown that although ABI contributes to CVD risk assessment, CIMT assessment remains the more sensitive method.
authors.affiliation: Institute of Microbiology and Immunology, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia, mateja.pirs@mf.uni-lj.si.
authors.forename: Mateja
authors.initials: M
authors.lastname: Pirs
authors.forename: Barbara
authors.initials: B
authors.lastname: Eržen
authors.forename: Mišo
authors.initials: M
authors.lastname: Sabović
authors.forename: Primož
authors.initials: P
authors.lastname: Karner
authors.forename: Ludvik
authors.initials: L
authors.lastname: Vidmar
authors.forename: Mario
authors.initials: M
authors.lastname: Poljak
authors.forename: Borut
authors.initials: B
authors.lastname: Jug
authors.forename: Mojca
authors.initials: M
authors.lastname: Mikac
authors.forename: Janez
authors.initials: J
authors.lastname: Tomažič
mesh_terms: D000328:Adult; D017677:Age Distribution; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D015897:Comorbidity; D015658:HIV Infections / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017524:Slovenia / Q000453:epidemiology