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Calcium score in the evaluation of atherosclerosis in patients with HIV/AIDS
Verônica Soares Monteiro1, Heloisa Ramos Lacerda, Marly Uellendahl
1Faculdade de Ciências Médicas, Universidade de Pernambuco, Brazil.
Insights
Atherosclerosis in HIV/AIDS patients is linked to age, smoking, and hypercholesterolemia, not antiretroviral therapy duration or type. This study highlights key risk factors for cardiovascular disease in this population.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Antiretroviral therapy (ART) has significantly improved life expectancy for individuals with HIV/AIDS.
- However, long-term ART use has been associated with an increased risk of atherosclerosis.
- Understanding atherosclerosis prevalence in this population is crucial for managing long-term health outcomes.
Purpose of the Study:
- To determine the prevalence of atherosclerosis in patients with AIDS receiving ART.
- To evaluate the impact of different ART regimens and treatment durations on atherosclerosis.
- To identify risk factors associated with atherosclerosis in this cohort.
Main Methods:
- Cardiac CT scans were used to quantify coronary artery calcium (CAC) score, defining atherosclerosis as CAC > 0.
- Lipid profiles and fasting glycemia were analyzed.
- Traditional risk factors, metabolic syndrome, and Framingham risk scores were assessed.
Main Results:
- Coronary atherosclerosis was present in 20.75% of the 53 patients studied.
- Neither the duration nor the type of ART regimen showed a significant association with atherosclerosis.
- Significant risk factors for atherosclerosis included age (OR = 20.59) and smoking (OR = 27.20), with a trend towards hypercholesterolemia (OR = 8.30).
Conclusions:
- Age, smoking, and hypercholesterolemia are key factors associated with atherosclerosis in patients with AIDS on ART.
- The duration and specific regimens of antiretroviral therapy did not influence the prevalence of atherosclerosis.
- These findings underscore the importance of managing traditional cardiovascular risk factors in HIV/AIDS patients undergoing long-term treatment.
Background:
Antiretroviral therapy has dramatically increased life expectancy in patients with HIV/AIDS although atherosclerosis has been associated with long-standing therapy.
Objective:
To investigate the prevalence of atherosclerosis in patients with AIDS undergoing antiretroviral therapy and the influence of different schemes and duration of treatment.
Methods:
HIV/AIDS patients were approached during routine consultations. Those who had been on antiretroviral therapy for at least two years had their blood collected for analysis of lipid profile and fasting glycemia and underwent cardiac CT for quantification of calcium score within six days at the most. Atherosclerosis was defined as calcium score greater than zero (CAC > 0). Traditional risk factors, metabolic syndrome and Framingham score were analyzed.
Results:
Fifty-three patients performed cardiac CT. Twenty-seven (50.94%) were male, mean age 43.4 years; 20.00% had hypertension, 3.77% diabetes, 67.92% hypercholesterolemia, 37.74% hypertriglyceridemia and 47.17% low HDL. Thirteen (24.53%) met criteria for metabolic syndrome and 96.23% were classified in Framingham score as "low risk." Ten patients (18.87%) were smokers. Mean duration of antiretroviral treatment was 58.98 months. Coronary atherosclerosis occurred in 11 (20.75%) patients. Duration of antiretroviral therapy was not related to atherosclerosis (p = 0.41) and there were no significant differences between different antiretroviral regimens (p = 0.71). Among traditional risk factors, smoking (OR = 27.20; p = 0.023) and age (OR = 20.59; p = 0.033) were significant in the presence of atherosclerosis. There was a trend towards a positive association of atherosclerosis with hypercholesterolemia (OR = 8.30; p = 0.0668).
Conclusion:
Factors associated with atherosclerosis were age, smoking and hypercholesterolemia. Duration and type of antiretroviral therapy had no influence on the prevalence of atherosclerosis.
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An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...