Associations between HIV serostatus and coronary artery plaque volume progression

Men with HIV have more coronary atherosclerosis than men without HIV. We examined whether plaque progression differed based on HIV serostatus.

We examined plaque progression over a median of 4.5 years [interquartile range (IQR) 3.9-4.9] among 548 men with ( n  = 313) or without ( n  = 235) HIV from the Multicenter AIDS Cohort Study using coronary CT angiography.

Change in coronary plaque volume was calculated for total, calcified, noncalcified, and low attenuation plaque and categorized by tertile. Multinomial logistic regression models estimated the association between HIV and coronary plaque progression.

The median age was 53 years and 30% were Black. Total plaque volume regressed among 2 and 20% remained without plaque, and 78% had progression with a median progression of 34 mm 3 (IQR 3-106). Compared to men without HIV, men with HIV had a statistically significant 1.99 higher odds of calcified plaque progression [95% confidence interval (CI) 1.16-3.44, P  = 0.01] and elevated odds for progression in total plaque [odds ratio (OR) 1.62, 95% CI: 0.94-2.77, P  = 0.08] and noncalcified plaque volume (OR 1.64, 95% CI 0.97-2.79, P  = 0.07], although the latter findings did not meet the cutpoint for statistical significance. The progression of low attenuation plaque did not significantly differ by HIV serostatus (OR 1.34, 95% CI: 0.88-2.05, P  = 0.18). HIV was significantly associated with the progression of total, calcified, and noncalcified plaque among non-Black participants, but not Black participants.

These results suggest that men with HIV may have greater plaque progression, which may contribute to the observed higher incidence of coronary heart disease among men with HIV.