Document Detail

Functional and structural markers of atherosclerosis in human immunodeficiency virus-infected patients.
MedLine Citation:
PMID:  16545639     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We investigated functional and structural markers of atherosclerosis in human immunodeficiency virus (HIV)-infected patients in relation to the presence of the metabolic syndrome (MS). BACKGROUND: Antiretroviral combination therapy in HIV has been associated with cardiovascular risk factors that cluster in the MS. METHODS: Thirty-seven HIV-infected patients underwent assessment of flow-mediated vasodilation (FMD), aortic pulse-wave velocity (PWV), and carotid intima-media thickness (IMT). Age-matched type 2 diabetic patients (n = 13) and healthy controls (n = 14) served as reference groups. RESULTS: Fifteen HIV-infected patients (41%) fulfilled the National Cholesterol Education Program criteria of the MS. The FMD was similarly impaired in HIV-infected patients without the MS (MS- group) and the diabetic patients (5.1 +/- 0.4% and 4.9 +/- 0.6%, respectively) compared with controls (8.8 +/- 0.7%). The HIV-infected patients with the MS (MS+ group) had even more impaired FMD (2.5 +/- 0.3%). Carotid IMT was similarly increased in the MS+ group and the diabetic patients compared with the other groups. Aortic PWV was increased in the diabetic patients only. In HIV-infected patients, FMD was related to metabolic parameters, whereas aortic PWV and IMT were related to parameters of HIV infection, time on antiretroviral combination therapy, inflammatory (C-reactive protein and leukocytes) and metabolic parameters. CONCLUSIONS: The data of the present study suggest an increased cardiovascular risk in HIV-infected patients, even in the absence of clustering of metabolic risk variables. The presence of the MS in HIV is associated with even more advanced atherosclerotic changes. Presumably, both HIV infection and antiretroviral therapy may promote atherosclerosis through mechanisms involving endothelial cells, either directly or indirectly via metabolic risk factors.
Jeroen P H van Wijk; Eelco J P de Koning; Manuel Castro Cabezas; Jorge Joven; Jos op't Roodt; Ton J Rabelink; Andy M Hoepelman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-02-23
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  47     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-20     Completed Date:  2006-05-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1117-23     Citation Subset:  AIM; IM    
Department of Internal Medicine and Infectious Disease, University Medical Center Utrecht, The Netherlands.
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MeSH Terms
Antiretroviral Therapy, Highly Active
Atherosclerosis / etiology*
HIV Infections / blood,  complications*,  drug therapy,  pathology,  physiopathology
Metabolic Syndrome X / etiology*
Middle Aged
Tunica Intima / pathology
Tunica Media / pathology
Comment In:
J Am Coll Cardiol. 2006 Mar 21;47(6):1124-5   [PMID:  16545640 ]

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