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Asymptomatic atherosclerosis in HIV-positive patients: A case-control ultrasound study
J Constans1, J M Marchand, C Conri
1Service de Médecine Interne et Pathologie Vasculaire, Hôpital Saint-André, Bordeaux, France.
Insights
HIV-positive individuals show higher rates of asymptomatic atherosclerosis, particularly linked to lower HDL cholesterol. This suggests increased cardiovascular risk in this population, even without traditional risk factors.
Area of Science:
- Cardiovascular disease research
- Infectious disease epidemiology
- Medical imaging and diagnostics
Background:
- Atherosclerosis is a growing concern in Human Immunodeficiency Virus (HIV)-positive individuals.
- Previous reports indicate atherosclerosis in HIV-positive subjects even without typical risk factors.
- Understanding subclinical atherosclerosis in HIV is crucial for risk stratification.
Purpose of the Study:
- To investigate the prevalence of atherosclerosis in cervical, abdominal aorta, and femoral arteries of HIV-positive subjects.
- To compare atherosclerosis rates between HIV-positive individuals and a matched control group.
- To identify potential associations between atherosclerosis and clinical factors in HIV-positive patients.
Main Methods:
- B-mode ultrasonography and Doppler assessment of arteries in 30 HIV-positive subjects and 18 controls.
- Matching controls for sex, age, tobacco consumption, and arterial hypertension.
- Analysis of plaque occurrence and association with HDL cholesterol and CD4-cell count.
Main Results:
- Plaques were found more frequently in HIV-positive patients (36.7%) compared to controls (11.1%) (P=0.05).
- HIV-positive patients with plaques showed a tendency towards lower HDL cholesterol, higher tobacco use, and lower CD4-cell counts.
- Lower HDL cholesterol was specifically noted in HIV-positive patients with plaques compared to controls (P=0.03).
Conclusions:
- Asymptomatic atherosclerosis appears more prevalent in HIV-positive patients.
- Lower HDL cholesterol is associated with atherosclerosis in this HIV-positive cohort.
- These findings highlight the need for cardiovascular risk assessment in HIV management.
Abstract:
Atherosclerosis has been reported in some HIV-positive subjects without any known risk factor. The purpose of the present study was to investigate cervical arteries, abdominal aorta and femoral arteries by B-mode ultrasonography and doppler in 30 HIV-positive subjects matched to 18 controls for sex, age, tobacco consumption and arterial hypertension. Although no haemodynamically or clinically relevant lesions were found, plaques occurred more often in patients than in controls (11 patients, 36.7% vs. 2, 11.1%; P = 0.05). Compared to the HIV-positive patients without plaques, those with plaques had a tendency to have decreased lower HDL cholesterol, higher tobacco consumption and lower CD4-cell count (77 +/- 85/mm3 vs. 220 +/- 202/mm3). The patients with plaques (but not those without plaques) had lower HDL cholesterol than controls (P = 0.03). Asymptomatic atherosclerosis seems to be more frequent in HIV-positive patients and is associated to lower HDL cholesterol.