The life expectancy in Human Immunodeficiency Virus (HIV) infected patients is increased after the introduction of Highly Active Antiretroviral Therapy (HAART). However, there is a growing concern of cardiovascular disease, in general and peripheral arterial disease (PAD), in particular in this population. A variety of atherogenic metabolic abnormalities including dyslipidemia, lipodystrophy and insulin resistance have been reported after the use of protease inhibitors (PI). Moreover, HIV causes direct injury to the arterial wall resulting in inflammation and atherosclerosis. This has led to the greater interest in detection of atherosclerosis by measuring carotid intimal thickening, endothelial dysfunction and coronary calcification. the prevalence of PAD is significantly higher in HIV population as compared to sex matched controls based on the abnormal ABI (10% Vs 1.3%; p Value 0.006) and the Claudication Questionaire (28.5% Vs 12.5%; p Value 0.0069). We also noticed that the age, Caucasian race, hypertension, diabetes mellitus, Non-HDL Cholesterol â¥ 4.91 mmol/l, HDL â¤ 1.03 mmol/l, Triglycerides â¥ 2.25 mmol/l, metabolic syndrome and low CD4 counts were identified as independent predictors of PAD in HIV-infected patients. An abnormal ABI is a marker of high vascular mortality and has been associated with lower 5-year survival rate. Therefore, it is very essential to identify patients with abnormal ABI to aggressively manage them to prolong survival. As mentioned previously, ABI measurements were performed by a single vascular specialist in the present study to negate the inter-observer bias. However, ABI testing can be easily performed by primary care physicians after minimal training, and should be routinely done for HIV patients. If abnormal ABI is found in HIV patients, their cardiovascular and infectious disease risk factors should be managed more aggressively. OMICS Group International is an open access online publishing group which has 700+ peer-reviewed journals, organizes 3000+ International Scientific Conferences per year, have around 50,000+ editorial board members and 1000+ Scientific associations. Medical Journals provide a platform for outstanding research around the globe in the field of medicine. These scholarly journals aim to contribute to the progress and application of scientific discoveries, by providing free access to the research information. The published work reaches the general public and the scientific community immediately after publication, thus providing higher citation rates for the author. Medical Journals are supported by 5000 internationally renowned editorial board members and a high quality review board. Medical Journals use online Editorial Manager System for quick and high quality review process. Articles of Medical journals are subjected to peer reviewing and these are included in the standard indexing databases like ISI, Scopus, EBSCO, CAS, HINARI etc. All the articles published in Medical journals are permanently archived in respective peer reviewed journals thus providing unrestricted utilization and requisition of the scientific information.
Last date updated on July, 2014