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Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus
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Coronary atherosclerotic lesions in human immunodeficiency virus-infected patients: a histopathologic study

Robert G Micheletti1, Gregory A Fishbein, Michael C Fishbein

  • 1University of California, Los Angeles, Los Angeles, CA, USA. rgm7@duke.edu

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|April 12, 2008
PubMed

Insights

Human immunodeficiency virus (HIV)-positive patients show increased coronary artery disease (CAD) with severe stenosis, lipid-rich plaques, and calcification. Atherosclerosis in these patients mirrors that in HIV-negative individuals, with no clear link to antiretroviral therapy in this study.

Area of Science:

  • Cardiovascular Pathology
  • Infectious Disease Research
  • HIV/AIDS Research

Background:

  • Studies indicate a higher risk of coronary artery disease (CAD) in human immunodeficiency virus-positive (HIV+) individuals.
  • However, detailed information on the histopathology, severity, and lesion distribution in HIV+ patients remains limited.

Purpose of the Study:

  • To investigate the histopathology, severity, and distribution of coronary artery lesions in deceased patients with acquired immunodeficiency syndrome (AIDS).
  • To compare the characteristics of coronary artery disease (CAD) in HIV+ individuals with HIV-negative controls.

Main Methods:

  • Coronary arteries from 66 deceased AIDS patients and 19 HIV-negative controls (age <55) were examined.
  • Stenosis, intimal lipid content, and calcification were graded. Medical histories and antiretroviral therapies were reviewed.

Main Results:

  • HIV+ patients exhibited significantly higher odds of severe stenosis (>or=75%) compared to controls, even after adjusting for age and sex.
  • HIV seropositivity was associated with increased plaque lipid content and calcification.
  • Older age and male sex were identified as risk factors for CAD in this cohort.

Conclusions:

  • Young to middle-aged patients with advanced AIDS present with atherosclerotic CAD characterized by luminal narrowing, heavy calcification, and high plaque lipid content.
  • The observed atherosclerosis patterns, lesion locations, and plaque compositions are typical of those seen in HIV-negative patients.
  • This study found no apparent relationship between antiretroviral therapies and atherosclerosis in a small cohort of heavily treated patients.
Abstract

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