Document Detail


Progression of carotid intima-media thickness in a contemporary human immunodeficiency virus cohort.
MedLine Citation:
PMID:  21860012     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Persons with human immunodeficiency virus (HIV) infection are at risk for premature cardiovascular disease (CVD). Predictors of atherosclerotic disease progression in contemporary patients have not been well described.
METHODS: Using data from a prospective observational cohort of adults infected with HIV (Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy), we assessed common carotid artery intima-media thickness (CIMT) at baseline and year 2 by ultrasound. We examined HIV-associated predictors of CIMT progression after adjusting for age, sex, race/ethnicity, body mass index, smoking, hypertension, diabetes, low-density lipoprotein cholesterol level, and baseline CIMT using linear regression.
RESULTS: Among 389 participants (median age at baseline, 42 years; male sex, 77%; median CD4+ cell count at baseline, 485 cells/mm³; 78% receiving antiretroviral therapy), the median 2-year CIMT change was 0.016 mm (interquartile range, -0.003 to 0.033 mm; P < .001). Lesser CIMT progression was associated with a suppressed viral load at baseline (-0.009 mm change; P = .015) and remaining virologically suppressed throughout follow-up (-0.011 mm change; P < .001). After adjusting for additional risk factors and a suppressed viral load during follow-up, nonnucleoside reverse transcriptase inhibitor versus protease inhibitor exposure was associated with lesser CIMT progression (-0.011 mm change; P = .02).
CONCLUSIONS: Suppressing HIV replication below clinical thresholds was associated with less progression of atherosclerosis. The proatherogenic mechanisms of HIV replication and the net CVD benefit of different antiretroviral drugs should be a focus of future research.
Authors:
Jason V Baker; W Keith Henry; Pragna Patel; Timothy J Bush; Lois J Conley; Wendy J Mack; E Turner Overton; Matt Budoff; John Hammer; Charles C Carpenter; Howard N Hodis; John T Brooks;
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2011-08-22
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  53     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-16     Completed Date:  2014-07-16     Revised Date:  2014-10-07    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  826-35     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-HIV Agents / adverse effects,  therapeutic use
CD4 Lymphocyte Count
Carotid Arteries / pathology*
Carotid Artery Diseases / complications,  prevention & control*,  virology
Carotid Intima-Media Thickness
Cohort Studies
Disease Progression
Female
Follow-Up Studies
HIV Infections / complications*,  drug therapy,  virology
HIV-1 / drug effects,  physiology*
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
RNA, Viral / genetics
Risk Factors
United States / epidemiology
Viral Load
Virus Replication / physiology*
Grant Support
ID/Acronym/Agency:
K12 RR023247/RR/NCRR NIH HHS; K12 RR023247/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/RNA, Viral
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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