António Pais de Lacerda
Hospital de Santa Maria, Portugal
Title: Atherosclerotic burden in patients infected with human immunodefi ciency virus: a carotid ultrasound and transcranial Doppler study
Biography
Biography: António Pais de Lacerda
Abstract
Human immunodeficiency virus (HIV) infection has been associated to premature atherosclerosis. Carotid intima-media thickness (CIMT) and pulsatility index (PI) accessed by carotid duplex ultrasonography (CDU) and transcranial Doppler (TCD), may be useful markers. Carotid and Cerebral circulation were evaluated by CDU and TCD in forty HIV-infected Caucasian men (mean age 49,4±5,9 years). CD4+ T-cell current and nadir counts, current and zenith viral load and duration of antiretroviral therapy (ART) were registered and cardiovascular risk scores were assessed. Multivariate regression analysis and Pearson’s correlation coefficient were used. All men received ART and presented mean CD4+ count of 817±369 cells/mm3, (mean nadir: 242,8 ±158,2 cells/mm3), 95% had non-detectable viral load (mean zenith: 381.416±858.881 copies/mm3), 35% of men had history of high blood pressure, 35% dyslipidaemia, 7,5% diabetes, 80% tobacco consumption. Mean Framingham Risk Score was 8,5±6,6%; 35% presented low risk by SCORE, 55% moderate risk and 7,5% high risk. Mean ASCVD score was 7±4% at 10 years and 49±12% lifetime. 67.5% men had increased CIMT (mean 0,92±0,13mm), but none presented increased PI. No correlation was found between duration of infection, ART or cardiovascular risk scores with CDU or TCD data. However, a significantly positive association between a CD4+ nadir count <400 cells/mm3 and an increase of 0,12 in PI, was confirmed by regression analysis where CD4 categories showed significant effect over PI (p=.04). In this series, HIV infection showed an association with premature cerebral atherosclerosis, even at low cardiovascular risk scores. PI may be an early marker of atherosclerosis in HIV-infected people with CD4+ nadir <400 cells/mm3