High Prevalence of Carotid Plaque Identified Using Standard Carotid Ultrasound Techniques in HIV-Positive Patients with Low to Moderate Vascular Risk
- *Corresponding Author:
- Gregory Bondy
Division of Endocrinology, Departments of Medicine and Pathology
University of British Columbia and Healthy Heart Program
St Paul’s Hospital, 1081 Burrard St. Vancouver, British Columbia, Canada
E-mail: [email protected]
Received date: June 17, 2014; Accepted date: June 29, 2014; Published date: August 12, 2014
Citation: Nguyen D, Stanek V, Guillemi S, Ding E, Colley G, et al. (2014) High Prevalence of Carotid Plaque Identified Using Standard Carotid Ultrasound Techniques in HIV-Positive Patients with Low to Moderate Vascular Risk. J AIDS Clin Res 5:338. doi:10.4172/2155-6113.1000338
Copyright: © 2014 Nguyen D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: People with HIV have an increased risk for developing atherosclerosis. The objective of our study was to measure the prevalence of carotid ultrasound abnormalities in HIV-positive patients receiving antiretroviral therapy using routine carotid ultrasound. We examined the association between abnormal carotid ultrasounds and traditional cardiovascular and HIV-related risk factors. Methods: A cross-sectional study was carried out on male HIV-positive patients with low-to-moderate cardiovascular risk attending the HIV Metabolic Clinic in Vancouver, British Columbia (BC). Carotid ultrasounds were performed between January 1, 2002 and June 30, 2012, and this information was used to establish patients overall cardiovascular risk. Patient's charts were reviewed to obtain clinical data for traditional and HIV-related risk factors. Antiretroviral treatment information was obtained from the provincial Drug Treatment Program (DTP) data-base. An abnormal carotid ultrasound was defined by the presence of carotid plaque(s) and was used as a surrogate marker for atherosclerotic cardiovascular disease. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation. Results: A total of 175 patients receiving antiretroviral therapy since 1996 were analyzed. The prevalence of carotid ultrasound abnormality was 47%. By multivariable analysis, the factors associated with carotid ultrasound abnormality included having history of high blood pressure (odds ratio 2.68, 95% confidence interval (CI): 1.17, 6.13) and a history of intravenous drug use (OR: 4.55, 95% CI: 1.40, 14.79). The odds ratios of carotid ultrasound abnormality for patients 46-55 years and ≥56 years old compared to ≤45 years old were 2.57 (95% CI: 1.08, 6.14) and 5.16 (95% CI: 2.02, 13.19), respectively. For every additional year on antiretroviral therapy, the odds ratio of abnormal carotid ultrasound increased by 1.10 (95% CI: 1.01, 1.19). Conclusion: Our study suggests that HIV-positive patients assessed as having low cardiovascular risk have a high prevalence of atherosclerotic vascular disease at younger ages. Some traditional factors and longer exposure to ARV's were associated with carotid ultrasound abnormalities.