title: Atherosclerosis is Evident in Treated HIV-Infected Subjects With Low Cardiovascular Risk by Carotid Cardiovascular Magnetic Resonance.
abstract: OBJECTIVE
  Premature atherosclerosis has been observed among HIV-infected individuals with high cardiovascular risk using one-dimensional ultrasound carotid intima-media thickness. We evaluated the assessment of HIV-infected individuals with low traditional cardiovascular disease risk using cardiovascular magnetic resonance, which allows three-dimensional assessment of the carotid artery wall.
  
  
  METHODS
  Carotid cardiovascular magnetic resonance was performed in 33 HIV-infected individuals (cases) (19 male, 14 female), and 35 HIV-negative controls (20 male, 15 female). Exclusion criteria included smoking, hypertension, hyperlipidemia (total cholesterol/HDL ratio > 5) or family history of premature atherosclerosis. Cases were stable on combination antiretroviral therapy with plasma HIV-1 RNA <50 copies per milliliter. Using computer modeling, the arterial wall, lumen, and total vessel volumes were calculated for a 4-cm length of each carotid artery centered on the bifurcation. The wall/outer-wall ratio (W/OW), an index of vascular thickening, was compared between the groups.
  
  
  RESULTS
  Cases had a median CD4 cell count of 690 cells per microliter. Mean (±SD) age and 10-year Framingham coronary risk scores were similar for cases and controls (45.2 ± 9.7 years versus 46.9 ± 11.6 years and 3.97% ± 3.9% versus 3.72% ± 3.5%, respectively). W/OW was significantly increased in cases compared with controls (36.7% versus 32.5%, P < 0.0001); this was more marked in HIV-infected females. HIV status was significantly associated with increased W/OW after adjusting for age (P < 0.0001). No significant association between antiretroviral type and W/OW was found-W/OW lowered comparing abacavir to zidovudine (P = 0.038), but statistical model fits poorly.
  
  
  CONCLUSIONS
  In a cohort of treated HIV-infected individuals with low measurable cardiovascular risk, we have observed evidence of premature subclinical atherosclerosis.
authors.affiliation: *Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom; †Section of Infectious Diseases, Department of Medicine, Imperial College London, London, United Kingdom; and ‡Division of Medicine, Brighton and Sussex Medical School, United Kingdom.
authors.forename: Kathleen A M
authors.initials: KA
authors.lastname: Rose
authors.forename: Jaime H
authors.initials: JH
authors.lastname: Vera
authors.forename: Peter
authors.initials: P
authors.lastname: Drivas
authors.forename: Winston
authors.initials: W
authors.lastname: Banya
authors.forename: Niall
authors.initials: N
authors.lastname: Keenan
authors.forename: Dudley J
authors.initials: DJ
authors.lastname: Pennell
authors.forename: Alan
authors.initials: A
authors.lastname: Winston
mesh_terms: D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000175:diagnosis* / Q000209:etiology; D018791:CD4 Lymphocyte Count; D002339:Carotid Arteries / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents