title: Associations between antiretroviral use and subclinical coronary atherosclerosis.
abstract: HIV infection is associated with increased prevalence of subclinical coronary plaque. The extent to which such plaque reflects effects of HIV infection or effects of long-term antiretroviral therapy (ART) use remains unclear and was the goal of this analysis.
  
  
  
  We compared the prevalence and extent of coronary plaque and stenosis between users of specific ART drugs or drug classes using coronary computed tomography (CT) among HIV-infected men in the Multicenter AIDS Cohort Study. To account for time-dependent confounders, including cardiovascular disease risk factors and time-varying reasons for using specific treatments, we conducted fully adjusted logistic and linear models with inverse probability of treatment weighting.
  
  
  
  There were 618 men who underwent noncontrast coronary CT; 450 also underwent coronary CT angiography. At the time of scanning, 81% had undetectable plasma HIV RNA. In fully adjusted models, cumulative use of zidovudine, abacavir, darunavir, and protease inhibitors as a drug class were inconsistently associated with specific forms of plaque presence or extent.
  
  
  
  Among virally suppressed HIV-infected men with extensive ART exposure, no consistent associations between use of specific ART drugs and both subclinical coronary plaque presence and extent were apparent. Our findings support the hypothesis that, among virally suppressed persons, type of ART used is not in general a major determinant of subclinical coronary plaque risk.
authors.affiliation: aDivision of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, Illinois bDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health cDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland dLos Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California eDepartment of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
authors.forename: Guajira P
authors.initials: GP
authors.lastname: Thomas
authors.forename: Xiuhong
authors.initials: X
authors.lastname: Li
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Jacobson
authors.forename: Mallory D
authors.initials: MD
authors.lastname: Witt
authors.forename: Todd T
authors.initials: TT
authors.lastname: Brown
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Kingsley
authors.forename: John P
authors.initials: JP
authors.lastname: Phair
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Palella
mesh_terms: D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D000072226:Computed Tomography Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D044966:Anti-Retroviral Agents