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Duration of HIV infection is associated with carotid artery stiffness
Presented by Eric C. Seaberg (United States).
E.C. Seaberg1, A.R. Sharrett1, H.N. Hodis2, W.J. Mack2, L.A. Kingsley3, L. Benning1, R.C. Kaplan4, J.P. Phair5, Multicenter AIDS Cohort Study (MACS)
1Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, Baltimore, United States, 2Keck School of Medicine, University of Southern California, Los Angeles, United States, 3University of Pittsburgh, Pittsburgh, United States, 4Albert Einstein College of Medicine, New York, United States, 5Northwestern University, Chicago, United States
Background: Increased cardiovascular disease (CVD) event rates have been reported among HIV infected persons with longer combination ART exposure. The mechanisms relating HIV infection or ART to CVD remain unknown. We tested the hypothesis that duration of HIV infection is associated with carotid artery stiffness.
Methods: MACS is an ongoing multicenter cohort study of HIV among men that began in 1984. Between 2004 and 2006, 915 MACS participants were enrolled into a prospective CVD substudy to evaluate changes in atherosclerosis and CVD risk factors. This investigation included 116 HIV seroconverters with known duration of HIV infection and a comparison group of 324 HIV uninfected men. High-resolution B-mode ultrasound of the right common carotid artery was conducted, and carotid artery stiffness was quantified using a distensibility index. We assessed the association between the distensibility index measured at the first study visit and the following participant characteristics using multiple linear regression: age, race, smoking, IDU history, family history of MI, diabetes, BMI, LDL-C, HDL-C, duration of HIV infection, CD4 count, HIV viral load, duration of HAART exposure, and cumulative exposure to PI- and NNRTI-based regimens.
Results: The mean age among the 440 men was 52.3 years, 74% were Caucasian, and 19% had a BMI >30 kg/m2. Multiple regression analysis revealed that older age, higher SBP, and HIV infection for >15 years were independently associated (p< 0.05) with decreased carotid artery distensibility. The magnitude of the decrease in carotid distensibility among men infected with HIV for >15 years (-13.4%) was comparable to the effect of aging 10 years (-11.5%) and a 10 mmHg increase in SBP (-11.5%).
Conclusions: Adjusted for CVD risk factors, prolonged HIV infection was independently associated with increased carotid artery stiffness, providing evidence that HIV may be associated with CVD via pathways that do not directly involve atherosclerosis/CVD disease risk factors.
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