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Risk of coronary artery disease in individuals infected with human immunodeficiency virus

Felippe Dantas Vilela1, Andrea Rocha de Lorenzo, Bernardo Rangel Tura

  • 1Cardiology, Instituto Nacional de Cardiologia, RJ, Brazil. felippevilela@gmail.com

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
|January 6, 2012
PubMed

Insights

Human immunodeficiency virus (HIV) patients show high cardiovascular disease risk factors, especially dyslipidemia. Coronary artery calcium scoring (CACS) reveals significant disease, indicating a need to reassess risk assessment strategies in this population.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Current human immunodeficiency virus (HIV) treatments improve survival but increase the risk of atherosclerotic coronary artery disease (CAD).
  • Specific strategies for reducing cardiovascular risk in HIV-infected individuals are underdeveloped.
  • Assessing the magnitude of cardiovascular risk in this population is crucial.

Purpose of the Study:

  • To evaluate cardiovascular risk in HIV-infected adults using the Framingham risk score (FRS).
  • To assess coronary artery calcium scoring (CACS) in this population.
  • To investigate the concordance between FRS and CACS for cardiovascular risk assessment.

Main Methods:

  • A cross-sectional study involving adults with HIV infection.
  • Collection of demographic, clinical, anthropometric, glucose, and lipid data.
  • Calculation of cardiovascular risk using FRS and CACS, with statistical analysis including Chi-square, Fisher's exact, Student t, Mann-Whitney, and kappa statistics.

Main Results:

  • High prevalence of CAD risk factors: dyslipidemia (67.5%), hypertension (55.0%), family history of CAD (57.5%), and smoking (35.0%).
  • Elevated HDL-cholesterol and triglycerides were frequent, particularly in protease inhibitor users.
  • FRS indicated low risk for 72.5%, while CACS > 0 was found in 32.5% of patients, with moderate to high scores in 32.5%.

Conclusions:

  • Dyslipidemia is the most prevalent CAD risk factor in HIV-infected individuals, often linked to protease inhibitor use.
  • The Framingham risk score may underestimate cardiovascular risk in this population.
  • Coronary artery calcium scoring (CACS) identifies subclinical atherosclerosis, highlighting the need for revised cardiovascular risk assessment strategies in HIV patients.
Abstract

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