Infect Chemother.  2022 Jun;54(2):308-315. 10.3947/ic.2022.0033.

The Role of Age in Subclinical Atherosclerosis in Asian People Living with Human Immunodeficiency Virus

• Park S
• Park SY
• Lee E
• Kim TH
• Lee E

• KMID: 2531020
• DOI: http://doi.org/10.3947/ic.2022.0033

Abstract

Background
People living with human immunodeficiency virus (PLHIV) have an increased risk of atherosclerosis and cardiovascular disease, but specific guidance on when to suspect the onset of these diseases is limited.
Materials and Methods
We aimed to identify cardiovascular risk factors in PLHIV using carotid intima-media thickness (IMT) through a cross-sectional, retrospective cohort study that enrolled 217 PLHIV who underwent carotid IMT measurement at a teaching hospital in Korea. We compared clinical characteristics between PLHIV with subclinical atherosclerosis and PLHIV with IMT within the normal range, and used a receiver operating characteristic curve to determine the cut-off age for predicting subclinical atherosclerosis.
Results
Among the study population, 115 participants (53.0%) had subclinical atherosclerosis. In logistic regression, age and dyslipidemia were significantly associated with increased carotid IMT even after adjusting for other variables (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.06 - 1.15, P <0.001; OR: 3.92, 95% CI: 1.87 - 8.22, P <0.001, respectively). The cut-off age for predicting subclinical atherosclerosis was 39.5 years (area under the curve 0.78, 95% CI: 0.72 - 0.84, P <0.001).
Conclusion
Conventional risk factors including age and dyslipidemia were associated with subclinical atherosclerosis in Asian PLHIV. In particular, Asian PLHIV older than 40 years had an increased risk of subclinical atherosclerosis and may benefit from carotid IMT screening.

Keyword

HIV; Carotid intima-media thickness; Risk factors; Dyslipidemia; Cardiovascular disease