Key result
HIV positive patients had a significantly higher prevalence of subclinical atherosclerosis compared to HIV negative healthy volunteers (51.9% vs 7.7%, p<0.001).
Why the study?
To evaluate the role of the traditional risk scoring system in detecting subclinical atherosclerosis in HIV (+) patients.
Does HIV infection increase the risk of subclinical atherosclerosis, and do traditional risk scoring systems adequately detect this risk compared to CIMT?
Cohort (n=104)
No
Does HIV infection increase the risk of subclinical atherosclerosis, and do traditional risk scoring systems adequately detect this risk compared to CIMT?
Absolute Event Rate: 51.9% vs 7.7%
p-value: p=<0.001
HIV(+) patients have a significantly higher prevalence of subclinical atherosclerosis that is not adequately captured by traditional cardiovascular risk scoring systems, suggesting a need for CIMT-inclusive risk models.
TRSS utility for subclinical atherosclerosis in HIV remains unclear; leaves open need for HIV-specific validation in larger cohorts.
BACKGROUND: To evaluate the role of the traditional risk scoring system (TRSS) in detecting subclinical atherosclerosis in HIV (+) patients. STUDY DESIGN: Cohort study. PLACE AND DURATION OF STUDY: Infectious Diseases Clinic, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, from March 2017 to January 2018. METHODOLOGY: The patient group was formed with 52 HIV (+) patients, aged 18-60 years, and a control group was formed with 52 HIV (-) healthy volunteers. For all groups, there was no comorbid diseases or family history. Diabetes mellitus, hypertension, chronic kidney disease and cardiovascular disease were excluded from the two groups. Carotid intima-media thickness (CIMT) measurements were performed with high resolution B mode Doppler USG and patients with subclinical atherosclerosis were identified by the presence of atheroma plaque. RESULTS: The median right CIMT measurement was 0.91 (0.73-0.97) mm and the median left CIMT was 0.90 (0.73-0.98) mm in HIV (+) patients. The median values of CIMT on right and left sides in the control group were 0.77 (0.67-0.81) mm and 0.76 (0.70-0.81) mm. Atheroma plaque was detected in 13.5% of the HIV (+) patients and in none of the control group. Subclinical atherosclerosis was found in 51.9% of HIV (+) patients and this rate was 7.7% in the HIV (-) group (p<0.001). There was a weak correlation between CIMT and TRSS. CONCLUSION: In this study, the scoring systems (Framingham, ACC/AHA CVHRS) that determine the risk of cardiovascular disease recommended in current practice and the results of CIMT measurements were not found to be compatible. The development of new scoring systems including CIMT testing for the determination of this risk will open important new horizons.
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Ozdemir et al. (2021) conducted a cohort in HIV (n=104). HIV infection vs. HIV (-) healthy volunteers was evaluated on Subclinical atherosclerosis (p=<0.001). HIV positive patients had a significantly higher prevalence of subclinical atherosclerosis compared to HIV negative healthy volunteers (51.9% vs 7.7%, p<0.001).
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