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Subclinical coronary atherosclerosis, HIV infection and antiretroviral therapy: Multicenter AIDS Cohort Study

Lawrence A Kingsley1, Juliana Cuervo-Rojas, Alvaro Muñoz

  • 1Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. kingsley@pitt.edu

AIDS (London, England)
|August 2, 2008
PubMed

Insights

Highly active antiretroviral therapy (HAART) may increase the odds of coronary artery calcification (CAC) presence but significantly reduces its extent in HIV-infected individuals. This suggests a complex relationship between HAART, HIV, and cardiovascular health.

Area of Science:

  • Cardiovascular Health
  • Infectious Diseases
  • Pharmacology

Background:

  • HIV infection is associated with increased cardiovascular disease risk.
  • Highly active antiretroviral therapy (HAART) is standard treatment for HIV.
  • The impact of HAART on coronary artery calcification (CAC) requires further investigation.

Purpose of the Study:

  • To assess the association between HIV infection and cumulative exposure to HAART.
  • To determine the relationship between HIV, HAART, and the presence and extent of CAC.

Main Methods:

  • Cross-sectional study of 947 male participants (HIV-seronegative, HAART-naive, and HAART-experienced).
  • CAC score measured using computed tomography.
  • Multivariable regression analysis adjusted for cardiovascular risk factors.

Main Results:

  • Increasing age was the strongest predictor of CAC presence and extent.
  • HIV infection and long-term HAART use were associated with increased odds of CAC presence.
  • However, the extent of CAC was significantly lower among HAART users, especially with over 8 years of use.

Conclusions:

  • HAART may have differential effects on CAC presence versus extent.
  • While HAART might marginally increase CAC prevalence, it significantly reduces CAC extent in HIV-infected individuals.
  • These findings highlight the complex interplay between HIV, HAART, and cardiovascular calcification.
Abstract

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