title: Increased coronary vessel wall thickness in HIV-infected young adults.
abstract: BACKGROUND
  Individuals with long-term human immunodeficiency virus (HIV) infection are at risk for premature vasculopathy and cardiovascular disease (CVD). We evaluated coronary vessel wall thickening, coronary plaque, and epicardial fat in patients infected with HIV early in life compared with healthy controls.
  
  
  METHODS
  This is a prospective cross-sectional study of 35 young adults who acquired HIV in early life and 11 healthy controls, free of CVD. Time resolved phase-sensitive dual inversion recovery black-blood vessel wall magnetic resonance imaging (TRAPD) was used to measure proximal right coronary artery (RCA) wall thickness, and multidetector computed tomography (CT) angiography was used to quantify coronary plaque and epicardial fat.
  
  
  RESULTS
  RCA vessel wall thickness was significantly increased in HIV-infected patients compared with sex- and race-matched controls (1.32 ± 0.21 mm vs 1.09 ± 0.14 mm, P = .002). No subject had discrete plaque on CT sufficient to cause luminal narrowing, and plaque was not related to RCA wall thickness. In multivariate regression analyses, smoking pack-years (P = .004) and HIV infection (P = .007) were independently associated with thicker RCA vessel walls. Epicardial fat did not differ between groups. Among the HIV-infected group, duration of antiretroviral therapy (ART) (P = .02), duration of stavudine exposure (P < .01), low-density lipoprotein cholesterol (P = .04), and smoking pack-years (P < .01) were positively correlated with RCA wall thickness.
  
  
  CONCLUSIONS
  This investigation provides evidence of subclinical coronary vascular disease among individuals infected with HIV in early life. Increased duration of ART, hyperlipidemia, and smoking contributed to proximal RCA thickening, independent of atherosclerotic plaque quantified by CT. These modifiable risk factors appear to influence early atherogenesis as measured by coronary wall thickness and may be important targets for CVD risk reduction.
authors.affiliation: Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases.
authors.forename: Khaled Z
authors.initials: KZ
authors.lastname: Abd-Elmoniem
authors.affiliation: Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases.
authors.forename: Aylin B
authors.initials: AB
authors.lastname: Unsal
authors.affiliation: Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases.
authors.forename: Sarah
authors.initials: S
authors.lastname: Eshera
authors.affiliation: Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases.
authors.forename: Jatin R
authors.initials: JR
authors.lastname: Matta
authors.affiliation: Critical Care Medicine Department, Clinical Center.
authors.forename: Nancy
authors.initials: N
authors.lastname: Muldoon
authors.affiliation: Critical Care Medicine Department, Clinical Center.
authors.forename: Dorothea
authors.initials: D
authors.lastname: McAreavey
authors.affiliation: Critical Care Medicine Department, Clinical Center.
authors.forename: Julia B
authors.initials: JB
authors.lastname: Purdy
authors.affiliation: Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Rohan
authors.initials: R
authors.lastname: Hazra
authors.affiliation: Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases.
authors.forename: Colleen
authors.initials: C
authors.lastname: Hadigan
authors.affiliation: Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Gharib
mesh_terms: D000293:Adolescent; D000328:Adult; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D055815:Young Adult
keywords: antiretroviral therapy; cardiovascular disease; coronary artery; perinatal HIV; smoking