title: Incidence and progression of coronary artery calcium in HIV-infected and HIV-uninfected men.
abstract: OBJECTIVE
  The aim of this article is to determine whether HIV-infected (HIV+) men have either higher incidence or more rapid progression of coronary artery calcium (CAC) compared with HIV-uninfected (HIV-) controls.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Multicenter study in four US academic research centers: University of Pittsburgh, Johns Hopkins University, University of California Los Angeles, and Northwestern University.
  
  
  METHODS
  Eight hundred and twenty-five men (541 HIV+ and 284 HIV-) enrolled in the cardiovascular substudy of the Multicenter AIDS Cohort Study who underwent serial cardiac computed tomography (CT) imaging during a mean follow-up of 5 years (range, 2-8 years).
  
  
  METHODS
  Incidence and progression of CAC assessed by cardiac CT.
  
  
  RESULTS
  During follow-up, 21% of HIV+ men developed incident CAC compared with 16% of HIV- men. This association persisted after adjustment for traditional and HIV-associated risk factors: hazard ratio 1.64 (1.13-3.14). However, there was no association between HIV serostatus and CAC progression among men with CAC present at baseline. Current smoking and increased insulin resistance, both modifiable risk factors, were independently associated with increased incidence of CAC. No evidence supporting an elevated risk for either CAC progression or incidence was found for either dyslipidemia or long-term usage of antiretroviral therapy.
  
  
  CONCLUSIONS
  In this large study of HIV+ and HIV- men who underwent serial cardiac CT scan imaging, HIV+ men were at significantly higher risk for development of CAC: hazard ratio 1.64 (1.13-3.14). In addition, two important and modifiable risk factors were identified for increased incidence of CAC. Taken together, these findings underscore the potential importance for smoking cessation and interventions to improve insulin resistance among HIV+ men.
authors.affiliation: aDepartment of Infectious Diseases and Microbiology bDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburg, Pennsylvania cJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland dLos Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California eNorthwestern University, Chicago, Illinois fSchool of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania gJohns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Kingsley
authors.forename: Jennifer
authors.initials: J
authors.lastname: Deal
authors.forename: Lisa
authors.initials: L
authors.lastname: Jacobson
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
authors.forename: Mallory
authors.initials: M
authors.lastname: Witt
authors.forename: Frank
authors.initials: F
authors.lastname: Palella
authors.forename: Bridget
authors.initials: B
authors.lastname: Calhoun
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
mesh_terms: D000046:Academic Medical Centers; D002118:Calcium / Q000032:analysis*; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000473:pathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology
chemical_list: D002118:Calcium