Progression of carotid artery intima-media thickening in HIV-infected and uninfected adults

被引:101
|
作者
Currier, Judith S. [1 ]
Kendall, Michelle A.
Henry, W. Keith
Beverly, Alston-Smith
Torriani, Francesca J.
Tebas, Pablo
Li, Yanjie
Hodis, Howard N.
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Infect Dis,Ctr Cllin AIDS Res & Educ, Los Angeles, CA 90024 USA
[2] Harvard Univ, Sch Publ Hlth, Stat & Data Anal Ctr, Boston, MA 02115 USA
[3] Univ Minnesota, Hennepin Cty Med Ctr, HIV Program, Minneapolis, MN 55415 USA
[4] NIAID, Div AIDS, Bethesda, MD 20892 USA
[5] Univ Calif San Diego, Dept Med, Div Infect Dis, San Diego, CA 92103 USA
[6] Univ Penn, Div Infect Dis, Philadelphia, PA 19104 USA
[7] Univ So Calif, Keck Sch Med, Div Cardiovasc Med, Atherosclerosis Res Unit, Los Angeles, CA USA
关键词
intima-media thickness; carotid artery; protease inhibitors; HIV;
D O I
10.1097/QAD.0b013e32811ebf79
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objectives: To compare the rate of change in intima-media thickness (IMT) of the carotid artery among uninfected subjects and HIV-infected subjects receiving or not receiving protease inhibitor (PI) regimens over a 144 week period. Design: This prospective, matched cohort study enrolled 133 subjects into 45 triads (groups of three subjects matched by age, sex, race/ethnicity, smoking status, blood pressure, and menopause) from university based outpatient HIV clinics. Each triad consisted of one subject from each of the following groups: 1, HIV-infected subjects with continuous use of PI therapy for >= 2 years; 2, HIV-infected subjects without prior PI use; 3, HIV-uninfected subjects. Methods: Standardized ultrasound images of carotid IMT were collected at weeks 0, 2, 24, 48, 72, 96, and 144. The main outcome was the yearly progression rate of carotid IMT (mm/year). Results: The median yearly IMT progression rate in groups 1, 2, and 3 was 0.0096, 0.0058, and 0.0085 mm/year, respectively. There were no statistically significant differences in progression between groups 1 and 2, or between the combined HIV-positive groups and the HIV-negative control group. A multicovariate model examining predictors of progression in carotid IMT among all subjects contained low density lipoprotein cholesterol and homocysteine. Among HIV subjects, predictors included nadir CD4 cell count and ritonavir use. Conclusions: HIV infection and PI use did not contribute substantially to the rate of carotid IMT progression in our matched study. (C) 2007 Lippincott Williams & Wilkins.
引用
收藏
页码:1137 / 1145
页数:9
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