JAC Advance Access originally published online on November 12, 2007
Journal of Antimicrobial Chemotherapy 2008 61(1):195-199; doi:10.1093/jac/dkm414
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Original research |
Predictive factors of vascular intima media thickness in HIV-positive subjects
1 Department of Medicine, Surgery and Dentistry, Institute of Infectious Diseases and Tropical Medicine, San Paolo Hospital, University of Milan, Via di Rudinì 8, 20142 Milan, Italy 2 Unit of Vascular Surgery, L. Sacco Hospital, Milan, Italy
Received 4 July 2007; returned 26 August 2007; revised 14 September 2007; accepted 8 October 2007
* Corresponding author. Tel: +39-0281843061; Fax: +39-0281843054; E-mail: marco.bongiovanni{at}unimi.it
Background: The predictive factors of intima media thickness (IMT) in the HIV-infected population are still poorly understood.
Patients and methods: We studied three groups of subjects, aged 30–50 years, to find potential predictive factors of carotid and/or femoral thickening (IMT > 1 mm in at least one area): healthy controls (G1, n = 54), HIV-infected naive (G2, n = 53) and highly active antiretroviral treatment (HAART)-treated subjects (G3, n = 133). All the subjects underwent ultrasonography of the carotid and femoral vessels to evaluate IMT.
Results: Demographic characteristics of the three groups were comparable, except for gender (G1 had a higher percentage of females) and lipid levels (higher in G3). A total of 115 subjects (47.9%) had carotid and/or femoral IMT: 26 in G1 (48.1%), 21 in G2 (39.6%) and 68 in G3 (51.1%). Independent predictive factors of carotid and/or femoral IMT were older age (OR: 2.81, 95% CI: 1.95–4.04, P < 0.01, for each additional 5 years), triglycerides 
150 mg/dL (OR: 2.66, 95% CI: 1.27–5.57, P < 0.001), serum glucose 110 mg/dL (OR: 5.24, 95% CI: 1.02–27.05, P = 0.04), high homocysteinaemia (OR: 2.75, 95% CI: 1.17–6.46, P = 0.02) and high body mass index (OR: 1.10, 95% CI: 1–1.22, P = 0.05 for each additional unit); females had a lower risk (OR: 0.38, 95% CI: 0.18–0.79, P < 0.01 versus males). HAART use was not associated with IMT (OR: 0.64, 95% CI: 0.27–1.53, P = 0.32 and OR: 0.80, 95% CI: 0.30–2.13, P = 0.20 for G3 and G2 versus G1, respectively).
Conclusions: This study demonstrates that traditional risk factors for cardiovascular diseases overshadow the role of HAART in determining premature vascular lesions.
Keywords: cardiovascular risk , Doppler , HAART