Carotid artery intima-media thickness and HIV infection: traditional risk factors overshadow impact of protease inhibitor exposure

被引:151
作者
Currier, JS
Kendall, MA
Zackin, R
Henry, WK
Alston-Smith, B
Torriani, FJ
Schouten, J
Mickelberg, K
Li, YJ
Hodis, HN
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Ctr Clin AIDS Res & Educ, Dept Med,Div Infect Dis, Los Angeles, CA USA
[2] Harvard Univ, Sch Publ Hlth, Stat & Data Anal Ctr, Boston, MA 02115 USA
[3] Univ Minnesota, Hennepin Cty Med Ctr, HIV Program, Minneapolis, MN USA
[4] NIAID, Div Aids, Bethesda, MD USA
[5] Univ Calif San Diego, Dept Med, Div Infect Dis, San Diego, CA 92103 USA
[6] Univ Washington, Dept Gen Surg, Seattle, WA 98195 USA
[7] Univ Penn, AIDS Clin Trials Unit, Philadelphia, PA 19104 USA
[8] Univ So Calif, Keck Sch Med, Div Cardiovasc Med, Atherosclerosis Res Unit, Los Angeles, CA 90089 USA
关键词
atherosclerosis; HIV infection; carotid intima-media thickness; protease inhibitors;
D O I
10.1097/01.aids.0000171406.53737.f9
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Context: The impact of HIV infection and exposure to antiretroviral therapy on the development of subclinical atherosclerosis is incompletely understood. Objective: To compare intima-media thickness (IMT) of the carotid artery between HIV-infected subjects receiving protease inhibitor-containing regimens and subjects not receiving these regimens and to compare differences in the IMT of the carotid artery between HIV-infected subjects and HIV-uninfected subjects. Methods: A prospective matched cohort study in university-based outpatient clinics. Groups of three individuals (triads) matched on the following characteristics were enrolled: age, sex, race/ethnicity, smoking status, blood pressure and menopausal status. Group 1, HIV-infected subjects with continuous use of protease inhibitor (PI) therapy for >= 2 years; group 2, HIV-infected subjects without prior PI use; and group 3: HIV-uninfected. Ultrasonographers at six sites sent standardized ultrasound images to a central reading site for carotid IMT measurements. Carotid IMT was compared within the HIV-infected groups (1 and 2) and between the HIV-infected and uninfected groups in a matched analysis. Results: One hundred and thirty-four individuals were enrolled in 45 triads. The median IMT in groups 1, 2 and 3 was 0.690, 0.712 and 0.698 mm, respectively. There were no statistically significant differences in IMT between groups 1 and 2, or in the combined HIV groups compared with the HIV uninfected group. Significant predictors of carotid IMT in a multivariate model included high-density lipoprotein (HDL) cholesterol, the interaction of HDL cholesterol and triglycerides, age and body mass index. Conclusions: We found no association between PI inhibitor exposure or HIV infection and carotid IMT. (c) 2005 Lippincott Williams & Wilkins.
引用
收藏
页码:927 / 933
页数:7
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