The Prevalence of Peripheral Arterial Disease in HIV PatientsNishant Gupta1, Sharad Bajaj1, Priyank Shah2*, Rupen Parikh1, Isha Gupta2, Wishwdeep Dhillon2, Vincent Debari3, Aiman Hamdan1, Fayez Shamoon4, Michae1Lange5 and Mahesh Bikkina1
- *Corresponding Author:
- Priyank Shah
249 Belleville Avenue
Apt. 21-B, Bloomfield
NJ 07003, USA
E-mail: [email protected]
Received Date: September 20, 2013; Accepted Date: October 26, 2013; Published Date: October 28, 2013
Citation: Gupta N, Bajaj S, Shah P, Parikh R, Gupta I, et al. (2013) The Prevalence of Peripheral Arterial Disease in HIV Patients. J Vasc Med Surg 1:118 doi: 10.4172/2329-6925.1000118
Copyright: © 2013 Gupta N, 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: The actual prevalence of Peripheral Arterial Disease (PAD) in Human Immunodeficiency Virus (HIV) infected patients is still unknown.
Aim: The aim of our study was to assess the prevalence of PAD using Ankle Brachial Index (ABI) (both rest and exercise) measurement in HIV infected patients with head-to-head comparison with the sex-matched non-HIV controls.
Methods: We randomly enrolled total of 214 patients (70 HIV patients and 144 non-HIV controls), from March 2009 to December 2009. The Edinburg Claudication Questionnaire and ABI were used as study tools. Normal ABI was defined as 0.9 to 1.3. Data was analyzed using the Fischer’s Exact Test. Various cardiovascular and infectious risk factors for PAD were also analyzed.
Results: Claudication was reported using Edinburgh questionnaire in 28.5% HIV patients as compared to 12.5 % patients in non-HIV group (p value 0.0069). Abnormal ABI suggestive of PAD i.e. ABI < 0.9 or >15% absolute drop on exercise was reported in 10% HIV patients as compared to 1.3% in non-HIV group (p value 0.006). Based on multivariate analysis, age, Caucasian race, hypertension, diabetes mellitus, hyperlipidemia, metabolic syndrome and low CD4 count were found to be independent predictors of PAD.
Conclusions: The prevalence of PAD is higher in HIV patients as compared to sex-matched non-HIV controls. Hence, HIV patients should be routinely screened for PAD using rest and exercise ABI. Apart from correlation with cardiovascular risk factors, strong association between lower CD4 cell count and abnormal ABI exists. This warrants more aggressive approach in managing cardiovascular and infectious markers in HIV patients with abnormal ABI.