The Role of Age in Subclinical Atherosclerosis in Asian People Living with Human Immunodeficiency Virus
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Background: People living with human immunodeficiency virus (PLHIV) have an increased risk of atherosclerosis and cardiovascular disease, but specific guidance on when to suspect the onset of these diseases is limited. Materials and methods: We aimed to identify cardiovascular risk factors in PLHIV using carotid intima-media thickness (IMT) through a cross-sectional, retrospective cohort study that enrolled 217 PLHIV who underwent carotid IMT measurement at a teaching hospital in Korea. We compared clinical characteristics between PLHIV with subclinical atherosclerosis and PLHIV with IMT within the normal range, and used a receiver operating characteristic curve to determine the cut-off age for predicting subclinical atherosclerosis. Results: Among the study population, 115 participants (53.0%) had subclinical atherosclerosis. In logistic regression, age and dyslipidemia were significantly associated with increased carotid IMT even after adjusting for other variables (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.06 - 1.15, P <0.001; OR: 3.92, 95% CI: 1.87 - 8.22, P <0.001, respectively). The cut-off age for predicting subclinical atherosclerosis was 39.5 years (area under the curve 0.78, 95% CI: 0.72 - 0.84, P <0.001). Conclusion: Conventional risk factors including age and dyslipidemia were associated with subclinical atherosclerosis in Asian PLHIV. In particular, Asian PLHIV older than 40 years had an increased risk of subclinical atherosclerosis and may benefit from carotid IMT screening.
Abstract
Background: People living with human immunodeficiency virus (PLHIV) have an increased risk of atherosclerosis and cardiovascular disease, but specific guidance on when to suspect the onset of these diseases is limited. Materials and methods: We aimed to identify cardiovascular risk factors in PLHIV using carotid intima-media thickness (IMT) through a cross-sectional, retrospective cohort study that enrolled 217 PLHIV who underwent carotid IMT measurement at a teaching hospital in Korea. We compared clinical characteristics between PLHIV with subclinical atherosclerosis and PLHIV with IMT within the normal range, and used a receiver operating characteristic curve to determine the cut-off age for predicting subclinical atherosclerosis. Results: Among the study population, 115 participants (53.0%) had subclinical atherosclerosis. In logistic regression, age and dyslipidemia were significantly associated with increased carotid IMT even after adjusting for other variables (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.06 - 1.15, P <0.001; OR: 3.92, 95% CI: 1.87 - 8.22, P <0.001, respectively). The cut-off age for predicting subclinical atherosclerosis was 39.5 years (area under the curve 0.78, 95% CI: 0.72 - 0.84, P <0.001). Conclusion: Conventional risk factors including age and dyslipidemia were associated with subclinical atherosclerosis in Asian PLHIV. In particular, Asian PLHIV older than 40 years had an increased risk of subclinical atherosclerosis and may benefit from carotid IMT screening.
참고문헌 (27)
- Hsue PY, "Role of viral replication, antiretroviral therapy, and immunodeficiency in HIV-associated atherosclerosis", AIDS, 23, pp.1059~1067 (2009)
- Currier JS, "Epidemiological evidence for cardiovascular disease in HIV-infected patients and relationship to highly active antiretroviral therapy", Circulation, 118, pp.e29~35 (2008)
- Deeks SG, "HIV infection, inflammation, immunosenescence, and aging", Annu Rev Med, 62, pp.141~155 (2011)
- Calmy A, "HIV increases markers of cardiovascular risk : results from a randomized, treatment interruption trial", AIDS, 23, pp.929~939 (2009)
- Islam FM, "Relative risk of cardiovascular disease among people living with HIV : a systematic review and meta-analysis", HIV Med, 13, pp.453~468 (2012)
- Hsue PY, "Progression of atherosclerosis as assessed by carotid intima-media thickness in patients with HIV infection", Circulation, 109, pp.1603~1608 (2004)
- Lichtenstein KA, "Low CD4+ T cell count is a risk factor for cardiovascular disease events in the HIV outpatient study", Clin Infect Dis, 51, pp.435~447 (2010)
- Stein JH, "Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine", J Am Soc Echocardiogr, 21, pp.93~111 (2008)
- Naghavi M, "From vulnerable plaque to vulnerable patient--Part III : Executive summary of the Screening for Heart Attack Prevention and Education(SHAPE)task force report", Am J Cardiol, 98(2A), pp.2H~15H (2006)
- Grunfeld C, "Preclinical atherosclerosis due to HIV infection : carotid intimamedial thickness measurements from the FRAM study", AIDS, 23, pp.1841~1849 (2009)
- Hsue PY, "Carotid intima-media thickness among human immunodeficiency virus-infected patients without coronary calcium", Am J Cardiol, 109, pp.742~747 (2012)
- Seminari E, "Assessment of atherosclerosis using carotid ultrasonography in a cohort of HIV-positive patients treated with protease inhibitors", Atherosclerosis, 162, pp.433~438 (2002)
- Johnsen S, "Carotid intimal medial thickness in human immunodeficiency virus-infected women : effects of protease inhibitor use, cardiac risk factors, and the metabolic syndrome", J Clin Endocrinol Metab, 91, pp.4916~4924 (2006)
- Bijker R, "Cardiovascular disease-related mortality and factors associated with cardiovascular events in the TREAT Asia HIV Observational Database(TAHOD)", HIV Med, 20, pp.183~191 (2019)
- Bild DE, "Ethnic differences in coronary calcification : the Multi-Ethnic Study of Atherosclerosis(MESA)", Circulation, 111, pp.1313~1320 (2005)
- Schneider E, "Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13years--United States, 2008", MMWR Recomm Rep, 57(RR-10), pp.1~12 (2008)
- Mangili A, "HIV infection and progression of carotid and coronary atherosclerosis : the CARE study", J Acquir Immune Defic Syndr, 58, pp.148~153 (2011)
- Feinstein MJ, "Characteristics, prevention, and management of cardiovascular disease in people living with HIV : A scientific statement from the American Heart Association", Circulation, 140, pp.e98~e124 (2019)
- Toth PP, "Subclinical atherosclerosis : what it is, what it means and what we can do about it", Int J Clin Pract, 62, pp.1246~1254 (2008)
- Prati P, "Prevalence and determinants of carotid atherosclerosis in a general population", Stroke, 23, pp.1705~1711 (1992)
- 정수진, "Clinical Factors Associated with Carotid Plaque and Intima-Medial Thickness in HIV-Infected Patients", Yonsei Medical Journal, 54(4), pp.990~998 (2013), 연세대학교의과대학[DOI]
- Jung Y, "HIV", AIDS notifications in Korea, 2019, 2020, pp.13, 2574~2579
- Lee E, "Suboptimal medication adherence in young women living with HIV infection : a Korean nationwide claims study", AIDS Care, 33, pp.938~942 (2021)
- Michos ED, "Framingham risk equation underestimates subclinical atherosclerosis risk in asymptomatic women", Atherosclerosis, 184, pp.201~206 (2006)
- Maggi P, "Colour-Doppler ultrasonography of carotid vessels in patients treated with antiretroviral therapy : a comparative study", AIDS, 18, pp.1023~1028 (2004)
- Maggi P, "Premature lesions of the carotid vessels in HIV-1-infected patients treated with protease inhibitors", AIDS, 14, pp.F123~F128 (2000)
- Stein JH, "A prospective, randomized clinical trial of antiretroviral therapies on carotid wall thickness", AIDS, 29, pp.1775~1783 (2015)