title: Low prevalence of peripheral arterial disease in a cross-sectional study of Danish HIV-infected patients.
abstract: BACKGROUND
  Patients infected with human immunodeficiency virus (HIV) appear to be at increased risk of cardiovascular disease (CVD). The ankle-brachial index (ABI) is a well-established screening tool for peripheral arterial disease (PAD) and future cardiovascular events in the general population. However, controversies exist on the prevalence of PAD among HIV-infected patients. In this study we aimed to measure the prevalence of PAD among HIV-infected patients and compare the ABI with carotid intima-media thickness (cIMT) and other known CVD risk predictors.
  
  
  METHODS
  We prospectively included HIV-infected patients from an outpatient clinic at the Department of Infectious Diseases, Hvidovre University Hospital, Denmark. We assessed the ABI pre- and post-exercise with a threshold for PAD defined as ABI ≤ 0.9. All patients had cIMT measured at the far wall of the distal common carotid artery.
  
  
  RESULTS
  Of 102 patients included (mean age 52 years, 75% male, 94% receiving antiretroviral therapy (ART), 33% active smokers), 1 had a pre-exercise ABI ≤ 0.9 and in addition 3 patients had a post-exercise ABI ≤ 0.9. We found a poor correlation between ABI and traditional CVD risk factors other than body mass index. In contrast, a strong correlation was found between cIMT and traditional risk factors. Values of post-exercise ABI and cIMT were not correlated. The current ART did not influence ABI values.
  
  
  CONCLUSIONS
  We found a low prevalence of PAD in HIV-infected patients. ABI did not correlate with CVD risk factors or cIMT. Based on these results ABI does not seem valuable as a screening tool for CVD among HIV-infected patients.
authors.affiliation: From the 1 Department of Infectious Diseases, Copenhagen University Hospital , Hvidovre , Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Knudsen
authors.forename: Catarina Anna Evelina
authors.initials: CA
authors.lastname: Malmberg
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjær
authors.forename: Anne-Mette
authors.initials: AM
authors.lastname: Lebech
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D019380:Anti-HIV Agents / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D019380:Anti-HIV Agents
keywords: HIV infection; atherosclerosis; carotid intima-media thickness; peripheral arterial disease