AEGiS-07CROI: Diagnosis and determinants of subclinical arterial disease in HIV1-infected patients on HAART.

7th Conference on Retroviruses and Opportunistic Infections

San Francisco, CA - January 30 -February 4, 2000

DIAGNOSIS AND DETERMINANTS OF SUBCLINICAL ARTERIAL DISEASE IN HIV1-INFECTED PATIENTS ON HAART.

Conf Retroviruses Opportunistic Infect 2000 Jan 30-Feb 2; 7:81 (abstract no. 31)

N. Cheminot¹, J. Gariepy², G. Chironi², L. Escaut¹, D. Vittecoq¹, And A. Simon²
¹Unité des Maladies Infectieuses et Tropicales, Hôpital Paul Brousse, Villejuif, France; and ²Ctr. de Médecine Préventive CardioVasculaire, Hôpital Broussais, Paris, France.

BACKGROUND: Metabolic disorders (insulinoresistance, lipid abnormalities, lipodystrophy) are common events in HIV infected patients. Cases of prenature myocardial infarction have been reported.

AIM: To assess carotid intima media thickness (IMT), a powerful surrogate for cardiovascular disease, in HIV infected patients receiving HAART, with at least one major cardiovascular risk factor (hypertension, hypercholesterolemia, hypoHDLemia, diabetes mellitus, abdominal adiposity or current smoking).

METHODS: Far wall IMT was measured in right common carotid. Blood pressure, lipids, fasting and postprandial glycemia and insulin, abdominal adiposity and smoking were evaluated.

RESULTS: 36 HIV patients (83% male) were assessed, of whom 88% received protease inhibitors. HIV patients had higher IMT (0.53 ± 0.09 mm, p=0.03) than healthy volunteers (employees of an insurance company) matched for age, sex, BMI and smoking (0.48 ± 0.08 mm). P-values of univariate, age adjusted (*), and multivariate significant association of IMT are shown in infected patients group in the table:

age	waist circumference	Chol/HDL
Univariate	0.02 0.02*	0.01*
Multivariate	0.01 0.05	0.03

No significant association existed with other cardiovascular risk factors (including insulin and smoking) or with CD4 cell counts and viral load, or with type and duration of antiretroviral therapy.

CONCLUSION: We showed that an early carotid wall thickening is present in HAART exposed patients and mainly mediated by certain but not all metabolic disturbances of insulinoresistance.

Keywords: AEGIS, Tunica Media, Antiretroviral Therapy, Highly Active, Tunica Intima, Cardiovascular Diseases, Body Mass Index, Prognosis, Obesity, Insulin Resistance, Insulin, Hypertension, Case-Control Studies, Male, Human, diagnosis, AIDS

2000-01-30
31

Copyright © 2000 - Foundation for Retrovirology and Human Health (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed from National Library of Medicine.