The Value of Carotid Intima-Media Thickness in the Detection of Atherosclerosis in HIV (+) Patients Subclinical Atherosclerosis in HIV (+)

Background: To evaluate the role of the traditional risk scoring system (TRSS) in detecting subclinical atherosclerosis in HIV (+) patients. Study Design: Cohort study. Place and Duration of Study: Infectious Diseases Clinic, Izmir Katip Celebi University, Ataturk Training and Research Hospital, from March 2017 to January 2018. Methodology: The patient group was formed with 52 HIV (+) patients, aged 18-60 years, and a control group was formed with 52 HIV (-) healthy volunteers. For all groups, there was no comorbid diseases or family history. Diabetes mellitus, hypertension, chronic kidney disease and cardiovascular disease were excluded from the two groups. Carotid intima-media thickness (CIMT) measurements were performed with high resolution B mode Doppler USG and patients with subclinical atherosclerosis were identified by the presence of atheroma plaque. Results: The median right CIMT measurement was 0.91 (0.73-0.97) mm and the median left CIMT was 0.90 (0.73-0.98) mm in HIV (+) patients. The median values of CIMT on right and left sides in the control group were 0.77 (0.67-0.81) mm and 0.76 (0.70-0.81) mm. Atheroma plaque was detected in 13.5% of the HIV (+) patients and in none of the control group. Subclinical atherosclerosis was found in 51.9% of HIV (+) patients and this rate was 7.7% in the HIV (-) group (p<0.001). There was a weak correlation between CIMT and TRSS. Conclusion: In this study, the scoring systems (Framingham, ACC/AHA CVHRS) that determine the risk of cardiovascular disease recommended in current practice and the results of CIMT measurements were not found to be compatible. The development of new scoring systems including CIMT testing for the determination of this risk will open important new horizons.