AEGiS-13IAC: Heamostatic markers of cardiovascular risk in HIV patients treated and untreated with protease inhibitors (PIs).

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Heamostatic markers of cardiovascular risk in HIV patients treated and untreated with protease inhibitors (PIs).

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrB760)

Seminari E, Pan A, Voltini G, Maserati R, Tinelli C, Meneghetti G, Carnevale G, Testa S
E. Seminari, Istituti Ospitalieri, Infectious Disease Dept, V. Concordia 1 26100, Cremona, Italy, Tel.: +390372405695, Fax: +390372405518, E-mail: ocrkl@tin.it

BACKGROUND: Patients infected with HIV may be at risk of atherosclerosis, and present evidence of endothelium dysfunction. The risk of development of cardiovascular disease may increase as a consequence of the body composition and metabolic changes known as "lipodistrophy", related to PIs use. In the last 2 years there has been an increase in reports of cardiovascular events in HIV subjects, possibly related to PI use. The objective of this study is to evaluate the haemostatic parameters of cardiovascular risk in patients treated and untreated with PIs. Methos: 27 HIV+ subjects divided into naive (11 pts) and PI experienced (16 pts) were enrolled in this study. Haemostatic parameters of cardiovascular risk (fibrinogen, FVII) as well as a marker of endothelial injury (thrombomodulin TM) were evaluated. Carotid duplex coded ultrasound color scan was performed.

RESULTS: The two groups were comparable for age, CD4 cell count and generic factors of cardiovascular disease (smoke, alcohol use, blood pressure). Mean plasma HIV-RNA load was 95,334 copies ml in naive and 913 copies/ml in PI treated patients.PI treatments regimens lasted a mean of 30 months (range: 20-41). Mean TM (55,8 ng/ml in naive and 54,6 ng/ml in treated patients) was increased in both groups. Among haemostatic parameters of cardiovascular risk, FVII was higher in treated than in untreated patients (130% and 93%, p = >0.05). Intimal thickening was found both in treated and untreated patients, but was more evident in the first group: 0.83 and 0.54 mm respectively (p = >0.01). Comments: Our data underline an increased haemostatic activation and intimal thickening in both naive and treated HIV+ patients. PI treated patients show an increase in FVII as well as an intimal thickening that may represent an adjunctive risk for cardiovascular disease. In patients at high risk, cardiovascular prophylaxis could be indicated.

Keywords: AEGIS, HIV Infections, Protease Inhibitors, HIV Seropositivity, CD4 Lymphocyte Count, Biological Markers, Arteriosclerosis, Human
000709
ThOrB760