Subclinical atherosclerosis in low Framingham risk HIV patients
© 2017 Stichting European Society for Clinical Investigation Journal Foundation..
BACKGROUND: Pathogenesis of atherosclerosis is complex, and differences between HIV-infected patients and general population cannot be completely explained by the higher prevalence of traditional cardiovascular risk factors. We aimed to analyse the association between inflammation and subclinical atherosclerosis in HIV patients with low Framingham risk score.
MATERIALS AND METHODS: Case-control study.
SETTING: Outpatient Infectious Diseases clinic in a university hospital.
SUBJECTS: HIV-1-infected patients aged > 35 years receiving antiretroviral treatment with viral load < 50 copies/mL and Framingham risk score < 10%.
EXCLUSION CRITERIA: inflammatory diseases; dyslipidaemia requiring statins; smoking > 5 cigarettes/day; diabetes; hypertension; vascular diseases.
MAIN OUTCOME: subclinical atherosclerosis determined by ultrasonography: common carotid intima-media thickness greater than 0·8 mm or carotid plaque presence. Explanatory variables: ribosomal bacterial DNA (rDNA), sCD14, interleukin-6 (IL-6) and TNF-α.
RESULTS: Eighty-four patients were included, 75% male, mean age 42 years and mean CD4+ cells 657 ± 215/mm3 . Median Framingham risk score was 1% at 10 years (percentile 25-75: 0·5-4%). Eighteen patients (21%) had subclinical atherosclerosis; the associated factors were older age (P = 0·001), waist-hip ratio (P = 0·01), time from HIV diagnosis (P = 0·02), rDNA (P = 0·04) and IL-6 (P = 0·01). In multivariate analysis, OR for subclinical atherosclerosis was 7 (95% CI, 1.3-40, P = 0.02) and 9 (95% CI, 1.0-85, P = 0.04) for patients older than 44 years and IL-6 > 6·6 pg/mL, respectively.
CONCLUSIONS: Well-controlled HIV patients with low Framingham risk score have a high prevalence of subclinical carotid atherosclerosis, and the main risk factors are age and inflammation. These patients are not receiving primary prophylaxis for cardiovascular events according to current guidelines.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
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| Enthalten in: |
European journal of clinical investigation - 47(2017), 8 vom: 01. Aug., Seite 591-599 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
León, Rafael [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-HIV Agents |
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| Anmerkungen: |
Date Completed 19.06.2018 Date Revised 20.06.2018 published: Print Citation Status MEDLINE |
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| doi: |
10.1111/eci.12780 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM273419102 |
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| 100 | 1 | |a León, Rafael |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Subclinical atherosclerosis in low Framingham risk HIV patients |
| 264 | 1 | |c 2017 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 19.06.2018 | ||
| 500 | |a Date Revised 20.06.2018 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2017 Stichting European Society for Clinical Investigation Journal Foundation. | ||
| 520 | |a BACKGROUND: Pathogenesis of atherosclerosis is complex, and differences between HIV-infected patients and general population cannot be completely explained by the higher prevalence of traditional cardiovascular risk factors. We aimed to analyse the association between inflammation and subclinical atherosclerosis in HIV patients with low Framingham risk score | ||
| 520 | |a MATERIALS AND METHODS: Case-control study | ||
| 520 | |a SETTING: Outpatient Infectious Diseases clinic in a university hospital | ||
| 520 | |a SUBJECTS: HIV-1-infected patients aged > 35 years receiving antiretroviral treatment with viral load < 50 copies/mL and Framingham risk score < 10% | ||
| 520 | |a EXCLUSION CRITERIA: inflammatory diseases; dyslipidaemia requiring statins; smoking > 5 cigarettes/day; diabetes; hypertension; vascular diseases | ||
| 520 | |a MAIN OUTCOME: subclinical atherosclerosis determined by ultrasonography: common carotid intima-media thickness greater than 0·8 mm or carotid plaque presence. Explanatory variables: ribosomal bacterial DNA (rDNA), sCD14, interleukin-6 (IL-6) and TNF-α | ||
| 520 | |a RESULTS: Eighty-four patients were included, 75% male, mean age 42 years and mean CD4+ cells 657 ± 215/mm3 . Median Framingham risk score was 1% at 10 years (percentile 25-75: 0·5-4%). Eighteen patients (21%) had subclinical atherosclerosis; the associated factors were older age (P = 0·001), waist-hip ratio (P = 0·01), time from HIV diagnosis (P = 0·02), rDNA (P = 0·04) and IL-6 (P = 0·01). In multivariate analysis, OR for subclinical atherosclerosis was 7 (95% CI, 1.3-40, P = 0.02) and 9 (95% CI, 1.0-85, P = 0.04) for patients older than 44 years and IL-6 > 6·6 pg/mL, respectively | ||
| 520 | |a CONCLUSIONS: Well-controlled HIV patients with low Framingham risk score have a high prevalence of subclinical carotid atherosclerosis, and the main risk factors are age and inflammation. These patients are not receiving primary prophylaxis for cardiovascular events according to current guidelines | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a inflammation | |
| 650 | 4 | |a intima-media thickness | |
| 650 | 4 | |a microbial translocation | |
| 650 | 4 | |a subclinical atherosclerosis | |
| 650 | 7 | |a Anti-HIV Agents |2 NLM | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 650 | 7 | |a DNA, Ribosomal |2 NLM | |
| 650 | 7 | |a Interleukin-6 |2 NLM | |
| 650 | 7 | |a Lipopolysaccharide Receptors |2 NLM | |
| 700 | 1 | |a Reus, Sergio |e verfasserin |4 aut | |
| 700 | 1 | |a López, Nicolás |e verfasserin |4 aut | |
| 700 | 1 | |a Portilla, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez-Payá, José |e verfasserin |4 aut | |
| 700 | 1 | |a Giner, Livia |e verfasserin |4 aut | |
| 700 | 1 | |a Boix, Vicente |e verfasserin |4 aut | |
| 700 | 1 | |a Merino, Esperanza |e verfasserin |4 aut | |
| 700 | 1 | |a Torrús, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Moreno-Pérez, Óscar |e verfasserin |4 aut | |
| 700 | 1 | |a Portilla, Joaquín |e verfasserin |4 aut | |
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