title: HIV infection is associated with an increased prevalence of coronary noncalcified plaque among participants with a coronary artery calcium score of zero: Multicenter AIDS Cohort Study (MACS).
abstract: OBJECTIVE
  HIV-infected individuals bear increased cardiovascular risk even in the absence of traditional cardiovascular risk factors. In the general population, coronary artery calcium (CAC) scanning is of value for cardiovascular risk stratification, but whether a CAC score of zero implies a low noncalcified coronary plaque burden in HIV-infected persons is unknown.
  
  
  METHODS
  We assessed the prevalence of noncalcified coronary plaque and compared noncalcified coronary plaque burden between HIV-infected and HIV-uninfected participants who had CAC scores of zero in the Multicenter AIDS Cohort Study (MACS) using coronary computed tomography (CT) angiography.
  
  
  RESULTS
  HIV infection was associated with the presence of noncalcified coronary plaque among these men with CAC scores of zero. In a model adjusted only for age, race, centre, and pre- or post-2001 cohort, the prevalence ratio for the presence of noncalcified plaque was 1.27 (95% confidence interval 1.04-1.56; P = 0.02). After additionally adjusting for cardiovascular risk factors, HIV infection remained associated with the presence of noncalcified coronary plaque (prevalence ratio 1.31; 95% confidence interval 1.07-1.6; P = 0.01).
  
  
  CONCLUSIONS
  Among men with CAC scores of zero, HIV infection is associated with an increased prevalence of noncalcified coronary plaque independent of traditional cardiovascular risk factors. This finding suggests that CAC scanning may underestimate plaque burden in HIV-infected men.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: T S
authors.initials: TS
authors.lastname: Metkus
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: T
authors.initials: T
authors.lastname: Brown
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Budoff
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Kingsley
authors.affiliation: Northwestern University, Chicago, IL, USA.
authors.forename: F J
authors.initials: FJ
authors.lastname: Palella
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Witt
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: R T
authors.initials: RT
authors.lastname: George
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: L P
authors.initials: LP
authors.lastname: Jacobson
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: W S
authors.initials: WS
authors.lastname: Post
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
keywords: coronary artery calcium score; coronary disease; risk stratificiation