title: HIV Infection Is Not Associated with Carotid Intima-Media Thickness in Brazil: A Cross-Sectional Analysis from the INI/ELSA-Brasil Study.
abstract: BACKGROUND
  Carotid intima-media thickness (cIMT) has been used as an early marker of atherosclerotic disease in the general population. Recently its role among HIV-infected patients has been questioned. To date, no Brazilian study has compared cIMT in respect to HIV status.
  
  
  METHODS
  We compared data from 535 patients actively followed in a prospective cohort in Rio de Janeiro (HIV group); 88 HIV-negative individuals who were nominated by patients (friend controls-FCs); and 10,943 participants of the ELSA-Brasil study. Linear regression models were used to study associations of the 3 groups and several covariables with cIMT. Propensity scores weighting (PSW) were also employed to balance data.
  
  
  RESULTS
  Median thickness in mm (IQR) were 0.54 (0.49,0.62); 0.58 (0.52,0.68); and 0.57 (0.49,0.70), HIV, FCs and ELSA-Brasil groups, respectively (p-value<0.001). The best linear model chosen did not include the group variables, after adjusting for all the variables chosen, showing no difference of cIMT across groups. Similar results were obtained with PSW. Several traditional CVD risk factors were also significantly associated with cIMT: female gender, higher education and higher HDL were negatively associated while risk factors were older age, current/former smoker, AMI/stroke family history, CVD history, hypertension, DM, higher BMI and total cholesterol.
  
  
  CONCLUSIONS
  We show for the first time in a middle-income setting that cIMT, is not different in HIV-infected patients in Rio de Janeiro compared with 2 different groups of non-HIV-infected individuals. Traditional CVD risk factors are associated with this outcome. Our results point out that high standards of care and prevention for CVD risk factors should always be sought both in the HIV-infected and non-infected populations to prevent CVD-related events.
authors.affiliation: FIOCRUZ, Programa de Computação Científica, Rio de Janeiro, Brazil.
authors.forename: Antonio G
authors.identifier: http://orcid.org/0000-0003-3095-1774
authors.initials: AG
authors.lastname: Pacheco
authors.affiliation: FIOCRUZ, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Grinsztejn
authors.affiliation: FIOCRUZ, Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Rio de Janeiro, Brazil.
authors.forename: Maria de Jesus M da
authors.initials: Mde J
authors.lastname: Fonseca
authors.affiliation: FIOCRUZ, Laboratory of Health and Environment Education, Rio de Janeiro, Brazil.
authors.forename: Rosane Härter
authors.initials: RH
authors.lastname: Griep
authors.affiliation: University of São Paulo, School of Medicine, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Lotufo
authors.affiliation: University of São Paulo, School of Medicine, São Paulo, Brazil.
authors.forename: Isabela
authors.initials: I
authors.lastname: Bensenor
authors.affiliation: Federal University of Espírito Santo, Departamento de Ciências Fisiológicas, Vitória, Brazil.
authors.forename: José G
authors.initials: JG
authors.lastname: Mill
authors.affiliation: FIOCRUZ, Programa de Computação Científica, Rio de Janeiro, Brazil.|FIOCRUZ, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
authors.forename: Rodrigo de C
authors.initials: Rde C
authors.lastname: Moreira
authors.affiliation: FIOCRUZ, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
authors.forename: Ronaldo I
authors.initials: RI
authors.lastname: Moreira
authors.affiliation: FIOCRUZ, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
authors.forename: Ruth K
authors.initials: RK
authors.lastname: Friedman
authors.affiliation: FIOCRUZ, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
authors.forename: Marilia
authors.initials: M
authors.lastname: Santini-Oliveira
authors.affiliation: FIOCRUZ, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
authors.forename: Sandra W
authors.initials: SW
authors.lastname: Cardoso
authors.affiliation: FIOCRUZ, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil.
authors.forename: Valdiléa G
authors.initials: VG
authors.lastname: Veloso
authors.affiliation: FIOCRUZ, Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Rio de Janeiro, Brazil.
authors.forename: Dóra
authors.initials: D
authors.lastname: Chor
mesh_terms: D000328:Adult; D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors