title: Greater carotid intima media thickness at a younger age in HIV-infected patients compared with reference values for an uninfected cohort.
abstract: In contrast to the general population, no decline in cardiovascular disease (CVD) has been noted in HIV-infected patients over the last 10 years. We compared the carotid artery intima media thickness (CIMT) of HIV-infected patients to that of age- and gender-matched reference values and determined the relationship between CVD risk factors and CIMT.
  
  
  
  A total of 292 HIV-infected patients were enrolled in the study. Data collected included vascular screening data, data obtained using a questionnaire, data obtained from laboratory assessments and CIMT measurement. Using linear regression (adjusted for age/gender/known HIV), the association between HIV-specific and classical cardiovascular risk factors and CIMT was evaluated.
  
  
  
  The cohort comprised for 91% of male patients, aged 49.4 ± 10.5 years, with a known duration of HIV infection of 8.8 ± 6.7 years. The mean with standard deviation (mean ± SD) CIMT was 0.77 ± 0.19 mm, compared with 0.58 ± 0.05 mm in the controls. A steeper increase of CIMT per age was seen in the HIV-infected patients. A significant relationship between CIMT and hypertension, diabetes mellitus, smoking, systolic blood pressure, HbA1c (glycated hemoglobin) and ankle brachial index was found. Of the HIV-specific variables, only a relationship between CIMT and length of cART use and between CIMT and (inversely) current cART use was seen.
  
  
  
  A greater CIMT was found in HIV-infected patients compared with controls. In contrast to HIV-specific variables, classical CVD risk factors were associated with a greater CIMT and should therefore be the focus of preventive measures.
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
authors.forename: M
authors.identifier: 0000-0001-8591-5784
authors.initials: M
authors.lastname: Krikke
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
authors.forename: J E
authors.initials: JE
authors.lastname: Arends
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.|Department of Internal Medicine & Gastroenterology, Spaarne Gasthuis, Haarlem, The Netherlands.
authors.forename: Sfl
authors.initials: S
authors.lastname: Van Lelyveld
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
authors.forename: Aim
authors.initials: A
authors.lastname: Hoepelman
authors.affiliation: Department of Vascular Medicine, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
authors.forename: Flj
authors.initials: F
authors.lastname: Visseren
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000453:epidemiology* / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values
keywords: (subclinical) atherosclerosis; HIV infection; cardiovascular disease; cardiovascular risk factors; carotid intima media thickness