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Carotid intima-media thickness in HIV patients treated with antiretroviral therapy

Anne-Mette Lebech1, Niels Wiinberg, Ulrik Sloth Kristoffersen

  • 1Department of Infectious Diseases, Hvidovre University Hospital, Hvidovre, Denmark. lebech@dadlnet.dk

Clinical Physiology and Functional Imaging
|April 21, 2007
PubMed

Insights

Cardiovascular risk in HIV patients on antiretroviral therapy (ART) was assessed using carotid artery intima-media thickness (IMT). No accelerated atherosclerosis was found, even in hypercholesterolemic patients, suggesting ART may not increase atherosclerosis risk.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Cardiovascular disease (CVD) risk is elevated in HIV patients on antiretroviral therapy (ART).
  • Potential causes include HIV infection, ART effects, or ART-induced dyslipidemia.
  • Atherosclerosis, a key CVD indicator, needs further investigation in this population.

Purpose of the Study:

  • To evaluate the relative contributions of HIV, ART, and dyslipidemia to atherosclerosis.
  • To compare carotid artery intima-media thickness (IMT) in HIV patients with varying cholesterol levels and healthy controls.

Main Methods:

  • Non-smoking HIV patients on ART with normal (<5.5 mmol/L) or high (≥6.5 mmol/L) cholesterol were compared to healthy controls.
  • Participants had no prior dyslipidemia or hypertension treatment.
  • Carotid artery intima-media thickness (IMT) was measured using ultrasonography.

Main Results:

  • No significant differences in IMT were observed between HIV patients (normal/high cholesterol) and controls.
  • IMT did not differ between patients receiving protease inhibitors and those not.
  • In HIV patients, IMT inversely correlated with HDL cholesterol (r=-0.50, P=0.01) but not LDL or total cholesterol.

Conclusions:

  • Accelerated atherosclerosis was not detected in non-smoking HIV patients on ART, including those with hypercholesterolemia, as assessed by IMT.
  • IMT correlated with HDL cholesterol, not LDL cholesterol, in this cohort.
  • The efficacy of selective LDL cholesterol reduction for mitigating CVD risk in non-smoking HIV patients warrants further investigation.
Abstract

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