Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients

Abstract

Background AIDS as well as atherosclerosis are important public health problems. The longer survival among HIV-infected is associated with increased number of cardiovascular events in this population, and this association is not fully understood.ObjectivesTo identify the frequency of subclinical atherosclerosis in HIV-infected patients compared to control subjects; to analyze associations between atherosclerosis and clinical and laboratory variables, cardiovascular risk factors, and the Framingham coronary heart disease risk score (FCRS).MethodsProspective cross-sectional case-control study assessing the presence of subclinical atherosclerosis in 264 HIV-infected patients and 279 controls. Clinical evaluation included ultrasound examination of the carotid arteries, arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx), laboratory analysis of peripheral blood, and cardiovascular risk according to FCRS criteria. The significance level adopted in the statistical analysis was p < 0.05.ResultsPlaques were found in 37% of the HIV group and 4% of controls (p < 0.001). Furthermore, carotid intima-media thickness was higher in the HIV group than in controls (p < 0.001). Patients with carotid plaque had higher fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and triglycerides than those without plaques. The presence of HIV, adjusted for age, overweight/obesity, and smoking increased by almost fivefold the risk of atherosclerotic carotid plaque (OR: 4.9; 95%CI: 2.5-9.9; p < 0.001). Exposure to protease inhibitors did not influence carotid intima-media thickness, was not associated with carotid plaque frequency, and did not alter the mechanical characteristics of the arterial system (PWV and AIx).ConclusionsHIV-infected patients are at increased risk of atherosclerosis in association with classical cardiovascular risk factors. Treatment with protease inhibitors does not promote functional changes in the arteries, and shows no association with increased frequency of atherosclerotic plaques in carotid arteries. The FCRS may be inappropriate for this population.

Frequency of subclinical atherosclerosis in HIV-infected Brazilians

“…The study “ Frequency of Subclinical Atherosclerosis in HIV-Infected Brazilians ”, 2 aimed at assessing those risk factors for cardiovascular disease, has reported results similar to those of other studies performed in several research centers around the world. It is worth noting the Multicenter AIDS Cohort Study (MACS) as a reference.…”

Worldwide relative smoking prevalence among people living with and without HIV

“…All male ---Restricted to 24 [67] Americas (Brazil) [53] European (France) [76] Africa (Uganda) 47% 48% Mean = 35 Mean = 35 Cross sectional PLH and HIV seronegative: drawn from a community cohort study in which PLH were age and sex matched to adults in the same district None identified [68] Americas (Canada) All identified as male…”

<p>Cardiovascular Risk in Individuals with Inflammatory Bowel Disease</p>

“…For sample size calculation, the chi-square test with the Yates' correction was used for two independent proportions, considering samples of different sizes. In a previous study, Salmazo et al 18 verified the frequency of atherosclerotic plaque in 4% of the subjects in the control group versus 37% of the HIV-infected patients. Considering the hypothesis of a lower frequency of atherosclerotic plaque in the carotid in patients with IBD compared with patients with HIV (approximately 20%) and considering the desired power of 0.8 and alpha of 0.05, we obtained a sample size of 76 individuals for the study.…”