Park Sunghee, Park Se Yoon, Lee Eunjung, Kim Tae Hyong, Lee Eunyoung
Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
Infect Chemother. 2022 Jun;54(2):308-315. doi: 10.3947/ic.2022.0033.
People living with human immunodeficiency virus (PLHIV) have an increased risk of atherosclerosis and cardiovascular disease, but specific guidance on when to suspect the onset of these diseases is limited.
We aimed to identify cardiovascular risk factors in PLHIV using carotid intima-media thickness (IMT) through a cross-sectional, retrospective cohort study that enrolled 217 PLHIV who underwent carotid IMT measurement at a teaching hospital in Korea. We compared clinical characteristics between PLHIV with subclinical atherosclerosis and PLHIV with IMT within the normal range, and used a receiver operating characteristic curve to determine the cut-off age for predicting subclinical atherosclerosis.
Among the study population, 115 participants (53.0%) had subclinical atherosclerosis. In logistic regression, age and dyslipidemia were significantly associated with increased carotid IMT even after adjusting for other variables (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.06 - 1.15, <0.001; OR: 3.92, 95% CI: 1.87 - 8.22, <0.001, respectively). The cut-off age for predicting subclinical atherosclerosis was 39.5 years (area under the curve 0.78, 95% CI: 0.72 - 0.84, <0.001).
Conventional risk factors including age and dyslipidemia were associated with subclinical atherosclerosis in Asian PLHIV. In particular, Asian PLHIV older than 40 years had an increased risk of subclinical atherosclerosis and may benefit from carotid IMT screening.
人类免疫缺陷病毒感染者（PLHIV）患动脉粥样硬化和心血管疾病的风险增加，但关于何时怀疑这些疾病发作的具体指导有限。
我们旨在通过一项横断面回顾性队列研究，利用颈动脉内膜中层厚度（IMT）确定PLHIV中的心血管危险因素，该研究纳入了217名在韩国一家教学医院接受颈动脉IMT测量的PLHIV。我们比较了亚临床动脉粥样硬化的PLHIV和IMT在正常范围内的PLHIV的临床特征，并使用受试者工作特征曲线确定预测亚临床动脉粥样硬化的临界年龄。
在研究人群中，115名参与者（53.0%）患有亚临床动脉粥样硬化。在逻辑回归分析中，即使在调整其他变量后，年龄和血脂异常与颈动脉IMT增加仍显著相关（优势比[OR]：1.11，95%置信区间[CI]：1.06 - 1.15，P<0.001；OR：3.92，95%CI：1.87 - 8.22，P<0.001）。预测亚临床动脉粥样硬化的临界年龄为39.5岁（曲线下面积0.78，95%CI：0.72 - 0.84，P<0.001）。
包括年龄和血脂异常在内的传统危险因素与亚洲PLHIV的亚临床动脉粥样硬化相关。特别是，40岁以上的亚洲PLHIV患亚临床动脉粥样硬化的风险增加，可能从颈动脉IMT筛查中获益。
