Rapid progression of carotid lesions in HAART-treated HIV-1 patients

Atherogenesis: Diseases that May Affect the Natural History “Schistosomiasis and HIV Infection”

“…Maggi et al evaluating patients with HIV and advocate the hypothesis that CMI is thickened more in the HIV group, which use the IP protocol is the cause of the thickening and that the lesions found in these patients are similar to arteritis and substantially different from atherosclerotic plaques [66], [69], [71], [72]. The present study does not confirm this hypothesis of thickening CMI in patients with HIV.…”

“…The study using IMT has been performed in patients with acquired immunodeficiency syndrome (AIDS) in the investigation of risk factors for atherosclerosis as an early marker, but there are few studies prospectivos [71], [72].…”

Ultrasonography in lesions of the carotid vessels in HIV positive patients

“…However, the actual role of these drugs in increasing the risk of atherosclerotic lesions of the carotid vessels in HIV-infected patients is still controversial [10][11][12][13]. Several factors are related to the onset of vascular lesions in HIV-infected patients, including the direct role of the virus in endothelial damage [9,[13][14][15] and the immune reconstitution subsequent to HAART [16].…”

“…Therefore, vascular damage could follow immunological mechanisms rather than traditional cardiovascular risk, such hypercholesterolaemia [13][14][15][16][17]. Indeed, whereas some carotid lesions identified are consistent with typical atheromatous plaques, others have a different structure, more similar to inflammatory infiltration of the carotid wall, even though it cannot be excluded that they may subsequently evolve towards the classic features of atheroma.…”

“…Questo riscontro ha suggerito l'ipotesi che gli PIs possano contribuire al danno aterosclerotico della parete vascolare, anche se i pazienti trattati con PIs presentano livelli più alti di trigliceridi che non di colesterolo highdensity lipoprotein (HDL) [4][5][6][7][8][9]. A tutt'oggi rimane tuttavia controverso il reale ruolo di questi farmaci nel determinare l'insorgenza di lesioni aterosclerotiche nei pazienti HIV positivi [10][11][12][13] la cui genesi potrebbe riconoscere molteplici fattori, come il ruolo diretto del virus sull'endotelio [9,[13][14][15] o la ricostituzione immunitaria successiva alla HAART [16].…”