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BackgroundThe risk of cardiovascular disease in human immunodeficiency virus (HIV)–infected patients is an increasing concern. We studied the changes in vascular properties after the initiation of combination antiretroviral therapy (cART) as well as the contribution of different drug classes MethodscART-naive men were randomized to receive either lopinavir/ritonavir (LPV/r) plus zidovudine/lamivudine (ZDV/3TC) (n=19) or LPV/r plus nevirapine (NVP) (n=18). Carotid artery intima-media thickness (C-IMT), arterial stiffness (distensibility coefficients DCs and compliance coefficients CCs of the carotid, femoral, and brachial arteries; carotid elastic modulus; and augmentation index), and markers of endothelial function (soluble vascular cell adhesion molecule sVCAM–1, intercellular adhesion molecule sICAM–1, plasma von Willebrand factor (vWF) antigen, and plasminogen activator inhibitor–1 antigen) and inflammation (high-sensitivity C-reactive protein) were measured before the initiation of cART and after 3, 12, and 24 months of cART ResultsC-IMT increased by 0.061±0.016 mm (P<.001) in the ZDV/3TC/LPV/r arm and by 0.044±0.018 mm (P=.012) in the NVP/LPV/r arm (data are estimated means ± SEs). Femoral artery DC (-1.66±0.78×10-3/kPa P=.035) and CC (-0.11±0.053 mm2/kPa P=.043) decreased in the ZDV/3TC/LPV/r arm and femoral DC decreased in the NVP/LPV/r arm (-1.72±0.85×10-3/kPa P=.046), with no significant difference in C-IMT or arterial stiffness between arms. sVCAM-1, sICAM-1, and vWF levels decreased significantly in both groups ConclusionC-IMT and femoral artery stiffness increased after the initiation of cART, whereas several markers of endothelial function improved, regardless of the composition of cART Trial registrationClinicalTrials.gov identifier: NCT00122226
Vonderen et al. (Tue,) studied this question.