Tags

Type your tag names separated by a space and hit enter

Low CD4 Cell Counts Are Associated with Carotid Plaque and Intima-Media Thickness in Virologically Suppressed HIV-Infected Asians Older Than 50 Years.
AIDS Res Hum Retroviruses 2019 Nov/Dec; 35(11-12):1160-1169AR

Abstract

Information about the prevalence, and risk factors for subclinical atherosclerosis in an Asian HIV-infected population is limited. Carotid intima-media thickness (cIMT) is one predictor for the risk of cardiovascular disease (CVDs) and mortality. We evaluated the prevalence and risk factors related to carotid atherosclerosis among well-suppressed HIV-infected adults receiving long-term ART from Thailand. This was a cross-sectional study of HIV-infected adults >50 years of age and free from CVDs from Thailand during 1 March 2016 and 30 May 2017. Ultrasonography of the carotid was performed and read by cIMT experienced neurologists who were blinded from the patient care. Subclinical atherosclerosis was defined by carotid plaque or cIMT of the common carotid artery (CCA) >0.9 mm. Totally 316 HIV-infected adults (61% males) were included. Median age was 54.4 years and 15.8% were diabetic, 40.2% had hypertension, and 12.7% were current smokers. The median duration of ART was 16.3 years and 32% were currently on boosted protease inhibitor. The mean overall cIMT of the common carotid arteries were 0.63 (IQR 0.55-0.72) mm. Men had higher cIMT than women, 0.64 (IQR 0.56-0.76) vs. 0.60 (IQR 0.53-0.70), p = .03. Overall, 3.8% had cIMT >0.9 mm and 24.4% had carotid plaque. From the multivariate logistic regression analysis, age per 1 year increase [odds ratio (OR) 1.06; 95% confidence interval (CI) 1.003-1.12; p = .04] and nadir CD4 < 200 cells/mm3 (OR 1.8; 95%CI 1.02-3.18, p = .04) were significantly associated with subclinical atherosclerosis. High-sensitivity C-reactive protein was not associated with subclinical atherosclerosis. In this well-suppressed HIV-infected Aging Asian cohort with relatively low prevalence of current smokers, 26.9% of them had subclinical atherosclerosis. Advanced age and low nadir CD4 cell count were significantly associated with subclinical atherosclerosis. Given that approximately a quarter of the patients had carotid plaques, longitudinal studies to evaluate the development of future overt coronary artery disease and stroke are warranted.

Authors+Show Affiliations

Department of Medicine, Faculty of Medicine, Chulalongkorn University, Chula Clinical Research Center, Bangkok, Thailand.Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand.The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand.The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand. Tuberculosis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand.Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand. Faculty of Medicine, Biostatistics Excellence Center, Chulalongkorn University, Bangkok, Thailand.The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand. Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Center, Bangkok, Thailand. Tuberculosis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31530175

Citation

Siwamogsatham, Sarawut, et al. "Low CD4 Cell Counts Are Associated With Carotid Plaque and Intima-Media Thickness in Virologically Suppressed HIV-Infected Asians Older Than 50 Years." AIDS Research and Human Retroviruses, vol. 35, no. 11-12, 2019, pp. 1160-1169.
Siwamogsatham S, Chutinet A, Vongsayan P, et al. Low CD4 Cell Counts Are Associated with Carotid Plaque and Intima-Media Thickness in Virologically Suppressed HIV-Infected Asians Older Than 50 Years. AIDS Res Hum Retroviruses. 2019;35(11-12):1160-1169.
Siwamogsatham, S., Chutinet, A., Vongsayan, P., Samajarn, J., Putcharoen, O., Aponpong, T., ... Avihingsanon, A. (2019). Low CD4 Cell Counts Are Associated with Carotid Plaque and Intima-Media Thickness in Virologically Suppressed HIV-Infected Asians Older Than 50 Years. AIDS Research and Human Retroviruses, 35(11-12), pp. 1160-1169. doi:10.1089/AID.2019.0126.
Siwamogsatham S, et al. Low CD4 Cell Counts Are Associated With Carotid Plaque and Intima-Media Thickness in Virologically Suppressed HIV-Infected Asians Older Than 50 Years. AIDS Res Hum Retroviruses. 2019;35(11-12):1160-1169. PubMed PMID: 31530175.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low CD4 Cell Counts Are Associated with Carotid Plaque and Intima-Media Thickness in Virologically Suppressed HIV-Infected Asians Older Than 50 Years. AU - Siwamogsatham,Sarawut, AU - Chutinet,Aurauma, AU - Vongsayan,Pongpat, AU - Samajarn,Jitrada, AU - Putcharoen,Opass, AU - Aponpong,Tanakorn, AU - Hiransuthikul,Akarin, AU - Gatechompol,Sivaporn, AU - Han,Win Min, AU - Chattranukulchai,Pairoj, AU - Kerr,Stephen J, AU - Ruxrungtham,Kiat, AU - Avihingsanon,Anchalee, AU - ,, Y1 - 2019/10/29/ PY - 2019/9/19/pubmed PY - 2019/9/19/medline PY - 2019/9/19/entrez KW - Asia KW - Thailand KW - cIMT KW - carotid plaque KW - subclinical atherosclerosis KW - well-suppressed HIV-infected patients SP - 1160 EP - 1169 JF - AIDS research and human retroviruses JO - AIDS Res. Hum. Retroviruses VL - 35 IS - 11-12 N2 - Information about the prevalence, and risk factors for subclinical atherosclerosis in an Asian HIV-infected population is limited. Carotid intima-media thickness (cIMT) is one predictor for the risk of cardiovascular disease (CVDs) and mortality. We evaluated the prevalence and risk factors related to carotid atherosclerosis among well-suppressed HIV-infected adults receiving long-term ART from Thailand. This was a cross-sectional study of HIV-infected adults >50 years of age and free from CVDs from Thailand during 1 March 2016 and 30 May 2017. Ultrasonography of the carotid was performed and read by cIMT experienced neurologists who were blinded from the patient care. Subclinical atherosclerosis was defined by carotid plaque or cIMT of the common carotid artery (CCA) >0.9 mm. Totally 316 HIV-infected adults (61% males) were included. Median age was 54.4 years and 15.8% were diabetic, 40.2% had hypertension, and 12.7% were current smokers. The median duration of ART was 16.3 years and 32% were currently on boosted protease inhibitor. The mean overall cIMT of the common carotid arteries were 0.63 (IQR 0.55-0.72) mm. Men had higher cIMT than women, 0.64 (IQR 0.56-0.76) vs. 0.60 (IQR 0.53-0.70), p = .03. Overall, 3.8% had cIMT >0.9 mm and 24.4% had carotid plaque. From the multivariate logistic regression analysis, age per 1 year increase [odds ratio (OR) 1.06; 95% confidence interval (CI) 1.003-1.12; p = .04] and nadir CD4 < 200 cells/mm3 (OR 1.8; 95%CI 1.02-3.18, p = .04) were significantly associated with subclinical atherosclerosis. High-sensitivity C-reactive protein was not associated with subclinical atherosclerosis. In this well-suppressed HIV-infected Aging Asian cohort with relatively low prevalence of current smokers, 26.9% of them had subclinical atherosclerosis. Advanced age and low nadir CD4 cell count were significantly associated with subclinical atherosclerosis. Given that approximately a quarter of the patients had carotid plaques, longitudinal studies to evaluate the development of future overt coronary artery disease and stroke are warranted. SN - 1931-8405 UR - https://www.unboundmedicine.com/medline/citation/31530175/Low_CD4_Cell_Counts_Are_Associated_with_Carotid_Plaque_and_Intima_Media_Thickness_in_Virologically_Suppressed_HIV_Infected_Asians_Older_Than_50_Years_ L2 - https://www.liebertpub.com/doi/full/10.1089/AID.2019.0126?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -