Arterial stiffness and carotid intima-media thickness in HIV infected patients

Background: Cardiovascular disease is an increasing cause of morbidity and mortality in HIV-infected patients. The increased cardiovascular risk is linked to traditional risk factors for atherosclerosis but also, to HIV infection itself which can damage the arterial wall and the antiretroviral therapy (ART) implicated in metabolic disturbances. The aim of our study was to identify the effects of HIV and ART on carotid artery intima-media thickness (C-IMT) and on arterial stiffness, parameters which are used for the evaluation of cardiovascular risk. Patients and methods: A cross-sectional case-control study of 63 HIV-infected patients (56 exposed to ART, 7 ART naive) and 36 controls matched for age and sex was performed. C-IMT, and arterial stiffness were measured ultrasonographically using an ALOKA ProSound alpha 10 echo-device. Parameters of arterial stiffness were measured at the common carotid and brachial arteries. Results: HIV-infected patients had a greater C-IMT than controls (p<0.01). There were significant differences regarding arterial stiffness parameters in HIV infected patients compared to controls, and between the groups of patients with different types of ART, especially at the level of carotid artery. Patients with HIV infection had reduced carotid compliance compared to controls (p<0.01). Patients exposed to reverse transcriptase inhibitort (RTI), had increased beta stiffness index (p=0.01) and carotid PWV (p=0.02) and reduced carotid compliance (p<0.01) compared to controls. Conclusions: HIV infection and ARV treatment is associated with increased C-IMT, and an increase in the arterial stiffness of the large arteries. These vascular modifications are possible causes of increased cardiovascular risk observed in HIV infected patients.