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Title: Traditional Factors More Important Than HIV-Associated Ones in Cardiovascular Disease Risk: Presented at CROI

"Traditional Factors More Important Than HIV-Associated Ones in Cardiovascular Disease Risk: Presented at CROI"

By Norra MacReady LOS ANGELES, CA -- March 6, 2007 -- Traditional cardiovascular risk factors contribute more to heart disease risk in HIV-positive people than do virus-associated factors, according to findings presented here at the 14[^th Conference on Retroviruses and Opportunistic Infections (CROI).

These data are part of the Study to Understand the Natural History of HIV/AIDS in the ERA of Effective Therapy (SUN), a 5-year, prospective cohort study designed to examine risk factors for complications associated with HIV management and longer survival.

The SUN findings were presented on February 28^th by lead author Kristin Mondy, MD, assistant professor of medicine, Washington University School of Medicine, St. Louis, Missouri, United States.

In this analysis, baseline values for carotid intima-media thickness (cIMT), coronary artery calcium scores (CACS), and Framingham risk scores (FRS) were collected on 628 participants, and independent predictors of increased cIMT were determined using multivariate logistic regression. Subgroup analyses were performed on 254 patients matched to HIV-negative controls, and on 265 SUN subjects for whom CACS were available. Increased cIMT was defined as any cIMT >0.715 mm.

Subjects had a mean cIMT of 0.73 mm, while control subjects had a mean cIMT of 0.70 mm (P = .005). The greatest single predictor of high cIMT was age >35 years, with an odds ratio (OR) of 3.93. Other risk factors were African-American race (OR = 2.38), hypertension (OR = 2.20), male sex (OR = 1.82), and weight >77 Kg or 169 lbs (OR = 1.70). Hispanic race was associated with a lower risk of increased cIMT (OR = 0.48).

Neither type nor duration of antiretroviral therapy had any impact on cIMT.

Compared with control subjects, the SUN subjects had higher serum triglyceride levels and lower high-density lipoprotein (HDL) cholesterol levels, but they also had lower low-density lipoprotein (LDL) cholesterol, a lower body mass index, and a lower overall Framingham risk score for cardiovascular disease, said Dr. Mondy.

Despite their greater cIMT, the HIV-positive patients in this cohort had a lower risk overall for cardiovascular disease than the HIV-negative controls, Dr. Mondy said in a poster presentation on February 28^th.

These patients will continue to be evaluated at 2-year intervals to gain a greater understanding of their chances of developing cardiovascular disease.

[Presentation title: Carotid Intima-Media Thickness (cIMT), Coronary Artery Calcium Scores (CACS), and Framingham Risk Scores (FRS) Among HIV-Infected Patients in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN). Poster 810]

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