Neither HIV infection nor the use of protease
inhibitors (PIs) appear to affect the rate of carotid artery intima
media thickening (IMT) progression, AIDS investigators report, despite
the lipid abnormalities that have been associated with PI therapy.
Dr. Judith S. Currier of the University of California at Los Angeles
and colleagues at multiple sites across the US conducted a prospective,
matched cohort study of 133 HIV clinic patients, divided into groups of
three and matched by age, sex, race/ethnicity, smoking status, blood
pressure and menopausal status.
Each group contained one HIV-positive patient who had been on
continuous PI therapy for at least two years, one HIV-positive patient
not on PI therapy and one HIV-uninfected subject.
Sequential carotid ultrasound imaging was conducted periodically over 144 weeks to measure rate of carotid IMT progression.
The median yearly carotid IMT progression rate was 0.0096 mm/year
among HIV subjects on PIs, 0.0058 mm/year among HIV subjects not taking
PIs and 0.0085 mm/year among uninfected individuals.
There were no significant differences between any of the three
groups, Dr. Currier and colleagues report in the May 31st issue of AIDS.
"Larger prospective studies are needed to determine the precise
contributions of specific antiviral agents to the progression of
carotid IMT," the investigators report. They expect that this
information will become more valuable as the HIV-infected population
ages and modifiable risk factors will need to be identified.
AIDS 2007;21:1137-1145.
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