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Associations between HIV infection and subclinical coronary atherosclerosis

Wendy S Post, Matthew Budoff, Lawrence Kingsley

    Annals of Internal Medicine
    |April 2, 2014
    PubMed

    Insights

    HIV-infected men show increased coronary artery plaque, particularly noncalcified types, compared to uninfected men. This finding highlights a higher prevalence of coronary atherosclerosis in individuals with HIV, independent of traditional risk factors.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Public Health

    Background:

    • Coronary artery disease (CAD) association with HIV infection requires further clarification.
    • HIV-infected individuals may face elevated cardiovascular risks.

    Purpose of the Study:

    • To investigate whether HIV-infected men exhibit greater coronary atherosclerosis than their uninfected counterparts.
    • To assess the prevalence and extent of coronary plaque in HIV-infected versus uninfected men.

    Main Methods:

    • Cross-sectional study within the Multicenter AIDS Cohort Study.
    • Inclusion of 618 HIV-infected and 383 uninfected men (aged 40-70) without prior coronary revascularization.
    • Assessment of coronary artery calcium (CAC), plaque presence/type, and stenosis using cardiac computed tomography (CT) and CT angiography.

    Main Results:

    • HIV-infected men had higher prevalence of CAC (PR 1.21) and any plaque (PR 1.14), including noncalcified (PR 1.28) and mixed plaque (PR 1.35).
    • These associations persisted after adjusting for traditional CAD risk factors.
    • HIV-infected men also showed a greater extent of noncalcified plaque and higher prevalence of >50% coronary stenosis (PR 1.48), though the latter was not significant after risk factor adjustment.

    Conclusions:

    • Coronary artery plaque, especially noncalcified plaque, is more prevalent and extensive in HIV-infected men.
    • Findings are independent of traditional cardiovascular disease risk factors.
    • Study limitations include cross-sectional design and male-only participants.
    Abstract

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