Subclinical atherosclerosis as detected by carotid ultrasound and associations with cardiac and HIV‐specific risk factors; the Archi‐Prevaleat project

• Published in: HIV medicine Vol. 24; no. 5; pp. 596 - 604
• Main Authors: Maggi, Paolo, Ricci, Elena Delfina, Muccini, Camilla, Galli, Laura, Celesia, Benedetto Maurizio, Ferrara, Sergio, Salameh, Yara, Basile, Rosa, Di Filippo, Giovanni, Taccari, Francesco, Tartaglia, Alessandra, Castagna, Antonella
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.05.2023
• Subjects: Algorithms; Antiretroviral agents; Arteriosclerosis; Atherosclerosis; Atherosclerosis - diagnostic imaging; Atherosclerosis - epidemiology; Blood glucose; Body mass; Body mass index; Body size; Cardiovascular diseases; cardiovascular risk; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Carotid Intima-Media Thickness; carotid vessels; CD4 antigen; Color; Comorbidity; Confidence intervals; Doppler effect; Dyslipidemia; Health risks; HIV; HIV Infections - complications; HIV Infections - drug therapy; Human immunodeficiency virus; Humans; intima‐media thickness; Lesions; Lipids; Male; Middle Aged; Plaque, Atherosclerotic - diagnostic imaging; Plaque, Atherosclerotic - epidemiology; Plaques; Risk Factors; Serum lipids; Sexually transmitted diseases; Statistical analysis; STD; Ultrasonic imaging; Ultrasonography; Ultrasonography, Carotid Arteries; intima-media thickness; cardiovascular risk; HIV; carotid vessels; plaques
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/hiv.13448

Objectives To evaluate the prevalence of carotid intima‐media thickness (IMT) and plaques in a cohort of people living with HIV (PLWH), the role of cardiovascular risk factors, the impact of the antiretroviral regimens and the difference between naïve and experienced patients in the onset of carotid lesions. Methods This project was initiated in 2019 and involves eight Italian centres. Carotid changes were detected using a power colour‐Doppler ultrasonography with 7.5 MHz probes. The following parameters were evaluated: IMT of both the right and left common and internal carotids, data regarding risk factors for cardiovascular disease, HIV viral load, CD4 cell counts, serum lipids, glycaemia and body mass index. The associations between pathological findings and potential risk factors were evaluated by logistical regression, with odds ratios (ORs) and 95% confidence intervals (95% CI)s. Results Among 1147 evaluated PLWH, with a mean age of 52 years, 347 (30.2%) had pathological findings (15.8% plaques and 14.5% IMT). Besides the usual risk factors, such as older age, male sex and dyslipidaemia, CD4 cell nadir < 200 cells/mL (adjusted OR = 1.51, 95% CI: 1.14–1.99) and current use of raltegravir (adjusted OR = 1.54, 95% CI: 1.01–2.36) were associated with higher prevalence of pathological findings. Conclusions Our data show that the current overall percentage of carotid impairments remains high. Colour‐Doppler ultrasonography could play a pivotal role in identifying and quantifying atherosclerotic lesions among PLWH, even at a very premature stage, and should be included in the algorithms of comorbidity management of these patients.