Assessment of atherosclerosis using carotid ultrasonography in a cohort of HIV-positive patients treated with protease

Objective: Lipid disorders associated with the use of protease inhibitors (PI) may be a risk factor for premature atherosclerosis development. The aim of this study is to evaluate the extend of carotid intima media thickness (IMT) among HIV-positive patients treated with PI containing regimens compared to PI-naive and HIV-negative subjects. Methods: We analysed plasma lipid level and carotid IMT in 28 HIV-positive patients treated with protease inhibitors (PIs) for a mean of 28.7 months (range 18-43) and in two control groups constituted, respectively, by 15 HIV-positive naive patients and 16 HIV-negative subjects, that were matched for age, risk factors for HIV infection, cigarette smoke use and CD4+ cell count. Results: PI-treated patients had higher triglyceride, HDL and apo B levels than controls, Carotid IMT was significantly increased in PI-treated patients compared to naive or HIV-negative subjects. A correlation between cholesterol HDL. triglyceride and ApoB levels and IMT as observed among the entire cohort. Conclusions: Plasma lipid alterations were associated with an increased IMT and intima media thickening was more Pronounced in PI-treated patients than in the two control groups. Periodical evaluation of blood lipid profile and. if required. the use of lipid-lowering agents is advisable. Moreover, physicians should address concurrent risk factor for atherosclerosis that can be modified, including smoking, hypertension, obesity and sedentary life-style. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.