Assessment of atherosclerosis using carotid ultrasonography in a cohort of HIV-positive patients treated with protease

被引:89
作者
Seminari, E
Pan, A
Voltini, G
Carnevale, G
Maserati, R [1 ]
Minoli, L
Meneghetti, G
Tinelli, C
Testa, S
机构
[1] Policlin San Matteo, IRCCS, Dept Infect Dis, I-27100 Pavia, Italy
[2] Ist Ospitalieri, Dept Infect Dis, Cremona, Italy
[3] Ist Ospitalieri, Dept Radiol, Cremona, Italy
[4] Policlin San Matteo, IRCCS, Biometry & Clin Epidemiol Unit, I-27100 Pavia, Italy
[5] Ist Ospitalieri, Coagulat Serv, Cremona, Italy
关键词
HIV-infection; antiretroviral therapy; protease inhibitor; intima media thickness; cardiovascular risk;
D O I
10.1016/S0021-9150(01)00736-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Lipid disorders associated with the use of protease inhibitors (PI) may be a risk factor for premature atherosclerosis development. The aim of this study is to evaluate the extend of carotid intima media thickness (IMT) among HIV-positive patients treated with PI containing regimens compared to PI-naive and HIV-negative subjects. Methods: We analysed plasma lipid level and carotid IMT in 28 HIV-positive patients treated with protease inhibitors (PIs) for a mean of 28.7 months (range 18-43) and in two control groups constituted, respectively, by 15 HIV-positive naive patients and 16 HIV-negative subjects, that were matched for age, risk factors for HIV infection, cigarette smoke use and CD4+ cell count. Results: PI-treated patients had higher triglyceride, HDL and apo B levels than controls, Carotid IMT was significantly increased in PI-treated patients compared to naive or HIV-negative subjects. A correlation between cholesterol HDL. triglyceride and ApoB levels and IMT as observed among the entire cohort. Conclusions: Plasma lipid alterations were associated with an increased IMT and intima media thickening was more Pronounced in PI-treated patients than in the two control groups. Periodical evaluation of blood lipid profile and. if required. the use of lipid-lowering agents is advisable. Moreover, physicians should address concurrent risk factor for atherosclerosis that can be modified, including smoking, hypertension, obesity and sedentary life-style. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:433 / 438
页数:6
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