[O25] Intima media thickness as cardiovascular risk marker in HIV-positive patients treated and untreated with protease inhibitors

2nd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV

13-15 September 2000, Toronto, Canada

INTIMA MEDIA THICKNESS AS CARDIOVASCULAR RISK MARKER IN HIV-POSITIVE PATIENTS TREATED AND UNTREATED WITH PROTEASE INHIBITORS

Antiviral Therapy 2000; 5(Suppl. 5):16 (abstract no. O25)

A Pan¹, E Seminari², G Voltini³, R Maserati², C Tinelli⁴, G Meneghetti², G Carnevale¹ and S Testa⁵
¹Department of Infectious Diseases, ³Department of Radiology, ⁵Biochemistry Laboratory, Cremona, Italy; ²Infectious Disease Department and ⁴Statistics Department, Pavia,Italy

BACKGROUND: In HIV-positive patients, the risk of development of cardiovascular disease may be increased as a consequence of the body alterations and metabolic changes related to protease inhibitor (PI) use.

OBJECTIVES: The objective of this study is to evaluate the carotid intima media thickness (IMT) in PI-treated patients compared with naïve and HIV-negative subjects.

DESIGN: HIV-positive patients treated for at least 18 months with PI, naïve HIV-positive patients and HIV-negative subjects were included. Patients were matched for age, sex, risk factors for HIV infection and cigarette use. Carotid duplex coded ultrasound colour scan was performed.

RESULTS: A total of 58 subjects were enrolled in this study: 28 HIV-positive PI-treated, 15 naïve and 16 HIV-negative subjects. PI treatment in combination regimens lasted a mean of 28.7 months (range, 18-43). The mean triglycerides value was 266 mg/dl in PI-treated patients, 133 mg/dl in naïve patients, and 106 mg/dl in HIV-negative subjects (P=0.005). HDL was higher in HIV-negative and naïve patients than in PI-treated patients (P=0.0011). The mean serum values of Apo B were 110 mg/dl in PI-treated patients, 86 and 82 mg/dl in naïve and HIV-negative subjects, respectively (P=0.018). FVII was higher in HIV-positive treated patients than in HIV-positive untreated (110 and 93%, respectively), fibrinogen was increased in PI-treated with respect to untreated subjects (327 versus 278 mg%), these differences were not significant. Mean carotid IMT was significantly increased in PI-treated patients than in naïve or HIV-negative subjects (mean 0.63,0.45 and 0.5 mm, respectively, P=0.00033).

COMMENTS: Carotid wall thickening is present in HAART-treated patients, and along with metabolic disturbances; these data confirm that risk factors for coronary artery disease are markedly elevated in PI exposed patients.

000913
O25

Copyright © 2000 - International Medical Press Ltd. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Medical Editor, International Medical Press, 36 St Mary-at-Hill, London EC3R 8DU, United Kingdom.