No abstract

Objectives HIV infected individuals bear increased cardiovascular risk even in the absence of traditional cardiovascular risk factors. In the general population, coronary artery calcium (CAC) scanning is of value for cardiovascular risk stratification, but whether a CAC score of zero implies a low non-calcified coronary plaque burden in HIV infected persons is unknown. Methods We assessed the prevalence of non-calcified coronary plaque and compared non-calcified coronary plaque burden between HIV infected and HIV uninfected participants who had CAC scores of zero in the Multicenter AIDS Cohort Study (MACS) using coronary CT angiography. Results HIV infection was associated with the presence of non-calcified coronary plaque among these men with CAC scores of zero. In a model adjusted only for age, race, center, and pre or post 2001 cohort, the prevalence ratio for the presence of non-calcified plaque was 1.27 (95% confidence interval 1.04–1.56, p = 0.02). After additionally adjusting for CVD risk factors, HIV infection remained associated with the presence of non-calcified coronary plaque (PR 1.31; 95% CI 1.07–1.6, p = 0.01). Conclusions In conclusion, among men with CAC scores of zero, HIV infection is associated with an increased prevalence of non-calcified coronary plaque independent of traditional cardiovascular risk factors. This finding suggests that CAC scanning may underestimate plaque burden in HIV infected men.