Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA.
J Acquir Immune Defic Syndr. 2013 Sep 1;64(1):51-7. doi: 10.1097/QAI.0b013e31829ed726.
To evaluate changes in cardiovascular disease risk surrogate markers in a longitudinal cohort of HIV-infected adults over 6 years.
Internal carotid artery (ICA) and common carotid artery (CCA) intima-media thickness (IMT), coronary artery calcium (CAC), vascular, and HIV risk factors were prospectively examined over 6 years in HIV-infected adults from 2002 to 2010.
Longitudinal cohort study with participants from urban center and surrounding communities.
SUBJECTS/PARTICIPANTS: Three hundred forty-five HIV-infected participants were recruited from a longitudinal cohort study. Two hundred eleven participants completed the study and were included in this analysis.
Total and yearly ICA and CCA IMT change; CAC score progression.
Participants were 27% female and 49% nonwhite; mean age at start was 45 ± 7 years. The median change in ICA and CCA over 6 years was 0.15 mm (0.08, 0.28) and 0.12 mm (0.09, 0.15), respectively. Age, baseline triglycerides ≥150 mg/dL, and pack-years smoking were associated with ICA IMT change; age, cholesterol, nadir CD4 count, and protease inhibitor use were associated with CCA IMT change. Diabetes, HIV viral load, and highly active antiretroviral therapy duration were associated with CAC progression.
Carotid IMT and CAC progressed in this HIV-infected cohort. Some HIV-specific characteristics were associated with surrogate marker changes, but the majority of risk factors continue to be traditional. Aggressive identification and management of modifiable risk factors may reduce progression of cardiovascular disease risk in this population.
评估在一个 6 年的 HIV 感染成年人纵向队列中，心血管疾病风险替代标志物的变化。
在 2002 年至 2010 年期间，对 HIV 感染成年人进行了前瞻性的颈内动脉（ICA）和颈总动脉（CCA）内膜中层厚度（IMT）、冠状动脉钙（CAC）、血管和 HIV 危险因素的检测。
有参与者来自城市中心和周边社区的纵向队列研究。
对象/参与者：从一个纵向队列研究中招募了 345 名 HIV 感染参与者。211 名参与者完成了这项研究，并被纳入了这项分析。
ICA 和 CCA 的总和年 IMT 变化；CAC 评分进展。
参与者中女性占 27%，非白人占 49%；起始时的平均年龄为 45±7 岁。6 年内 ICA 和 CCA 的中位数变化分别为 0.15mm（0.08，0.28）和 0.12mm（0.09，0.15）。年龄、基线甘油三酯≥150mg/dL 和吸烟包年数与 ICA IMT 变化相关；年龄、胆固醇、最低 CD4 计数和蛋白酶抑制剂的使用与 CCA IMT 变化相关。糖尿病、HIV 病毒载量和高效抗逆转录病毒治疗的持续时间与 CAC 的进展相关。
在这个 HIV 感染队列中，颈动脉 IMT 和 CAC 进展。一些 HIV 特有的特征与替代标志物的变化有关，但大多数危险因素仍然是传统的。积极识别和管理可改变的危险因素可能会降低该人群心血管疾病风险的进展。
