Associations of antiretroviral drug use and HIV-specific risk factors with carotid intima-media thickness.

Abstract

BACKGROUND:

Previous research has demonstrated an increase in carotid intima-media thickness (cIMT) in HIV-infected individuals compared to controls. However, the reason for this increased level of subclinical vascular disease is unknown.

OBJECTIVE:

To identify HIV-related risk factors for increased cIMT.

METHODS:

We evaluated the relationship between HIV-related characteristics (including markers of HIV disease severity and use of antiretroviral therapy) and cIMT measurements in the internal/bulb and common carotid regions among 538 HIV-infected participants from the Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM). We used Bayesian model averaging to estimate the posterior probability of candidate HIV and non-HIV-related risk factors being true predictors of increased cIMT. Variables with a posterior probability of more than 50% were used to develop a selected regression model for each of the anatomic regions.

RESULTS:

For common cIMT, the Bayesian model selection process identified age, African-American race, and systolic and diastolic blood pressure with probability more than 95%, HDL cholesterol with probability 85% and Hispanic ethnicity with probability 51%. Among the HIV-related factors included in the analysis, only tenofovir use was selected (51% probability). In the selected model, duration of tenofovir use was associated with lower common cIMT (-0.0094 mm/year of use; 95% confidence interval: -0.0177 to -0.0010). For internal cIMT, no HIV-related risk factors were above the 50% posterior probability threshold.

CONCLUSION:

We observed an inverse association between duration of tenofovir use and common carotid cIMT. Whether this association is causal or due to confounding by indication needs further investigation.

• Authors: Joseph A C Delaney, Rebecca Scherzer, Mary L Biggs, Michael G Shliplak, Joseph F Polak, Judith S Currier, Richard A Kronmal, Christine Wanke, Peter Bacchetti, Daniel O'leary, Phyllis C Tien, Carl Grunfeld
• Journal: AIDS (London, England) (AIDS) Vol. 24 Issue 14 Pg. 2201-9 (Sep 10 2010) ISSN: 1473-5571 [Electronic] England
• PMID: 20671544 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Organophosphonates
• Tenofovir
• Adenine

Topics

• Adenine (administration & dosage, adverse effects, analogs & derivatives)
• Antiretroviral Therapy, Highly Active
• Atherosclerosis (chemically induced, pathology, virology)
• Female
• HIV Infections (complications, drug therapy)
• HIV-1
• Humans
• Male
• Middle Aged
• Organophosphonates (administration & dosage, adverse effects)
• Risk Factors
• Tenofovir
• Tunica Intima (pathology)
• Tunica Media (pathology)