Progression of Atherosclerosis in HIV-infected Individuals - Prospective Data from an Asian Cohort.

BACKGROUND: The magnitude and risk factors of progression of atherosclerosis in Asian HIV-infected individuals were unknown. This study aimed to evaluate: (1) the rate of progression of atherosclerosis in HIV-infected individuals, and (2) metabolic and inflammatory parameters that may predict atherosclerosis progression in HIV-infected individuals in an Asian cohort.

SETTING: A prospective, longitudinal study was performed among adults attending an HIV Metabolic clinic in Hong Kong.

METHODS: Carotid intima media thickness (cIMT) was measured at baseline and 24 months. Body composition, metabolic, and inflammatory biomarkers (including HOMA-IR, LDL cholesterol particle size, hsCRP, adiponectin) associated with cIMT change were analyzed; their predictive performances were estimated using ROC analyses.

RESULTS: Sixty-one HIV-infected individuals (mean±SD age 49.8±11.4 years, 89% male, 97% Chinese, diabetes 39%, hypertension 30%, dyslipidemia 85%) were recruited. Annual rate of change of cIMT was +0.0075 (0.0000-0.0163) mm/year, and 19% developed new plaque at 24 months. Two patients died during the study period, one due to sudden cardiac death. Using ROC analyses, combination of lower limb fat percentage, LDL cholesterol subclass pattern B, and lower adiponectin level, but not Framingham score, predicted greater cIMT progression in HIV-infected individuals.

CONCLUSION: Asian HIV-infected individuals had atherosclerosis progression. Limb fat percentage, LDL cholesterol particle size, and adiponectin level may identify at-risk Asian HIV-infected individuals for early intervention.