International Journal of STD & AIDS > Volume 20, Number 10 > Pp. 683-689

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Original research articles

Cardiovascular risk factors and ultrasound evaluation of carotid atherosclerosis in patients with HIV-1 infection

L Calza MD ^* , G Verucchi MD ^*, D Pocaterra MD ^*, M Pavoni MD ^*, A Alfieri MD ^*, A Cicognani MD ^*, R Manfredi MD ^*, C Serra MD  and F Chiodo MD ^*

^* Department of Internal Medicine, Geriatrics and Nephrologic Diseases, Section of Infectious Diseases; Department of Internal Medicine and Gastroenterology, ‘Alma Mater Studiorum’ University of Bologna, S. Orsola-Malpighi Hospital, via G. Massarenti, 11 40138 Bologna, Italy

Correspondence to: Dr L Calza Email: leonardo.calza{at}unibo.it

A cross-sectional study was performed to evaluate classical risk factors for cardiovascular diseases and subclinical atherosclerosis by carotid ultrasonography in HIV-positive subjects, naïve or treated with antiretroviral agents. A total of 66 patients were enrolled into the study: 21 subjects were naïve to all antiretroviral agents (group A) and 45 patients were treated with antiretroviral therapy for 36 months (group B). The prevalence of carotid plaques was significantly higher in group B than in group A (44.7% versus 0%; P = 0.014). In group B, patients with high 10-year risk of coronary heart disease showed a significantly higher intima-media thickness and prevalence of carotid lesions than those with low risk. Moreover, carotid lesions were structurally comparable to classical atherosclerotique plaques observed in the general population, with iso-hyperechonegic aspects and irregular surfaces. The prevalence of carotid atherosclerosis in experienced patients is higher than in those naïve to highly active antiretroviral therapy and seems mostly associated with a longer duration of HIV infection, more severe lipid metabolism alterations, presence of lipodystrophy syndrome and a more elevated 10-year risk of cardiovascular diseases.

Key Words: HAART • toxicity • AIDS • cardiovascular diseases • carotid atherosclerosis

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