Colour-Doppler ultrasonography of carotid vessels in patients treated with antiretroviral therapy

Abstract

These data confirm the higher prevalence of premature carotid lesions in the PI-treated patients. A periodic ultrasonographic study of the vascular wall should be included in the follow-up of HIV infected patients.

High Prevalence of Carotid Plaque Identified Using Standard Carotid Ultrasound Techniques in HIV-Positive Patients with Low to Moderate Vascular Risk

“…Previous observational studies that investigated the relationship between protease inhibitor and carotid plaques produced conflicting results [19,23,[29][30][31]. Maggi demonstrated that protease inhibitor exposure was associated with carotid plaques [29,30] while other observational studies failed to show this association [19,23,31]. Although protease inhibitor exposure was not significantly associated with abnormal carotid ultrasound in our analysis, we found that longer duration of antiretroviral therapy was associated with an abnormal result.…”

“…After adjusting for serum lipid levels, the relative risk remained significant at 1.10, suggesting that protease inhibitors contribute to cardiovascular disease through different mechanisms. Previous observational studies that investigated the relationship between protease inhibitor and carotid plaques produced conflicting results [19,23,[29][30][31]. Maggi demonstrated that protease inhibitor exposure was associated with carotid plaques [29,30] while other observational studies failed to show this association [19,23,31].…”

Metabolic syndrome in HIV-infected patients receiving antiretroviral therapy in Latin America

“…16 Others have found that patients with higher CD4 cell counts (> 200 cells/mm 3 ) had higher rates of vessel thickening, a surrogate marker for CVD, than patients with lower CD4 cell counts. 20 Female gender was one of the strongest predictors of MS in our study, despite a male predominance in the sample population. While a very high prevalence of MS among females from the USA has been reported recently, 21 this finding is rather unique in the literature, and may represent a distinctive feature of the Latin American region.…”

Impact of Treatment With Protease Inhibitors on Aortic Stiffness in Adult Patients With Human Immunodeficiency Virus Infection

“…9 A number of previous studies has shown an association between use of protease inhibitors and early vascular structural and functional changes in HIV-infected children 23,24 and adults. 4,5,25 In particular, endothelial dysfunction, 5 increased carotid intima-media thickness, 25 and carotid atherosclerotic plaques 4 have been reported in HIV-infected adults. Several potential mechanisms may underlie the association between treatment with protease inhibitors and large-artery stiffness.…”

“…This finding supports the hypothesis that immunodepression determined by HIV infection might in itself contribute to accelerate the atherosclerotic process. 4,24,25 Dyslipidemia, insulin resistance, inflammation, impaired fibrinolysis, and activation of vascular endothelium mediated by chronic HIV-induced low-grade inflammation 31,32 may also play a role in this regard.…”