James H Stein1, Todd T Brown, Heather J Ribaudo, Yun Chen, Mingzhu Yan, Elizabeth Lauer-Brodell, Grace A McComsey, Michael P Dubé, Robert L Murphy, Howard N Hodis, Judith S Currier. 1. aUniversity of Wisconsin School of Medicine and Public Health, Madison, Wisconsin bJohns Hopkins University, Baltimore, Maryland cCenter for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts dUniversity of Southern California, Los Angeles, California eCase Western Reserve School of Medicine, Cleveland, Ohio fFeinberg School of Medicine, Northwestern University, Chicago, Illinois gDavid Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.
Abstract
OBJECTIVE: To evaluate associations between traditional cardiovascular disease (CVD) risk factors, inflammatory markers and markers of HIV disease activity with ultrasonographic measures of CVD risk in patients with HIV who are not receiving antiretroviral therapy (ART). DESIGN: Cross-sectional, baseline evaluation of ART-naive HIV-infected individuals without known CVD or diabetes mellitus enrolled in a randomized ART treatment trial. METHODS: Prior to ART initiation, carotid artery intima-media thickness (CIMT) and brachial artery flow-mediated dilation (FMD) were measured. Additional parameters included CD4 cell count, HIV viral load, body composition, lipoproteins and inflammatory markers. Associations with common CIMT, bifurcation CIMT, presence of carotid artery lesions and brachial artery FMD were evaluated. RESULTS: The 331 enrolled individuals were a median (first-third quartile) of 36 (28-45) years old. Common and bifurcation CIMT values were higher and lesions more prevalent with older age (P < 0.001). FMD was lower with older age (P = 0.009). Those with a Framingham Risk Score of at least 6% per 10 years (N = 44) had higher common and bifurcation CIMT (P < 0.001), carotid lesion prevalence (P < 0.001) and lower FMD (P = 0.035). Independent associations with common CIMT were identified for increasing age, height, weight, small low-density lipoprotein (LDL) particles and black race; these were similar for bifurcation CIMT. Presence of carotid artery lesions was associated with increasing age, presence of metabolic syndrome, interleukin-6 and lower HIV-1 RNA. CONCLUSION: In a contemporary cohort of ART-naive HIV-infected individuals, ultrasonographic measures of CVD risk were more strongly associated with traditional risk factors than CD4 cell counts, HIV replication or inflammatory markers.
RCT Entities:
OBJECTIVE: To evaluate associations between traditional cardiovascular disease (CVD) risk factors, inflammatory markers and markers of HIV disease activity with ultrasonographic measures of CVD risk in patients with HIV who are not receiving antiretroviral therapy (ART). DESIGN: Cross-sectional, baseline evaluation of ART-naive HIV-infected individuals without known CVD or diabetes mellitus enrolled in a randomized ART treatment trial. METHODS: Prior to ART initiation, carotid artery intima-media thickness (CIMT) and brachial artery flow-mediated dilation (FMD) were measured. Additional parameters included CD4 cell count, HIV viral load, body composition, lipoproteins and inflammatory markers. Associations with common CIMT, bifurcation CIMT, presence of carotid artery lesions and brachial artery FMD were evaluated. RESULTS: The 331 enrolled individuals were a median (first-third quartile) of 36 (28-45) years old. Common and bifurcation CIMT values were higher and lesions more prevalent with older age (P < 0.001). FMD was lower with older age (P = 0.009). Those with a Framingham Risk Score of at least 6% per 10 years (N = 44) had higher common and bifurcation CIMT (P < 0.001), carotid lesion prevalence (P < 0.001) and lower FMD (P = 0.035). Independent associations with common CIMT were identified for increasing age, height, weight, small low-density lipoprotein (LDL) particles and black race; these were similar for bifurcation CIMT. Presence of carotid artery lesions was associated with increasing age, presence of metabolic syndrome, interleukin-6 and lower HIV-1 RNA. CONCLUSION: In a contemporary cohort of ART-naive HIV-infected individuals, ultrasonographic measures of CVD risk were more strongly associated with traditional risk factors than CD4 cell counts, HIV replication or inflammatory markers.
Authors: Theodoros Kelesidis; Thuy Tien T Tran; James H Stein; Todd T Brown; Carlee Moser; Heather J Ribaudo; Michael P Dube; Robert Murphy; Otto O Yang; Judith S Currier; Grace A McComsey Journal: Clin Infect Dis Date: 2015-04-22 Impact factor: 9.079
Authors: Priscilla Y Hsue; Heather J Ribaudo; Steven G Deeks; Tanvir Bell; Paul M Ridker; Carl Fichtenbaum; Eric S Daar; Diane Havlir; Eunice Yeh; Ahmed Tawakol; Michael Lederman; Judith S Currier; James H Stein Journal: Clin Infect Dis Date: 2019-05-17 Impact factor: 9.079
Authors: James H Stein; Eunice Yeh; Joanne M Weber; Claudia Korcarz; Paul M Ridker; Ahmed Tawakol; Priscilla Y Hsue; Judith S Currier; Heather Ribaudo; Carol K C Mitchell Journal: Arterioscler Thromb Vasc Biol Date: 2018-12 Impact factor: 8.311
Authors: Michael P Dubé; Lauren Komarow; Carl J Fichtenbaum; Joseph J Cadden; Edgar T Overton; Howard N Hodis; Judith S Currier; James H Stein Journal: Clin Infect Dis Date: 2015-05-15 Impact factor: 9.079
Authors: Corrilynn O Hileman; Randi Turner; Nicholas T Funderburg; Richard D Semba; Grace A McComsey Journal: AIDS Date: 2016-01-02 Impact factor: 4.177
Authors: Nath Zungsontiporn; Lishomwa C Ndhlovu; Brooks I Mitchell; James H Stein; Kalpana J Kallianpur; Beau Nakamoto; Sheila M Keating; Philip J Norris; Scott A Souza; Cecilia M Shikuma; Dominic C Chow Journal: HIV Clin Trials Date: 2015-11