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Colegio de Medicina Interna de México.

2008, Number 4

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Med Int Mex 2008; 24 (4)

Cardiovascular risk in HIV patients

Castro SC, Santos RA, Guerrero FA, Rodríguez SR, Góngora BRA, Bolaños CE, Valencia SN, Sarmiento CC, Castelo NA

Language: Spanish
References: 16
Page: 284-288
PDF size: 155.18 Kb.


ABSTRACT

Background: Antiretroviral therapy in HIV patients has caused lipid and glucose metabolism alterations.
Objective: To compare prevalence of cardiovascular risk at 10 years over 10%, in a group of HIV-infected patients with HAART, and another without HAART.
Patients and methods: A clinical-epidemiological, multicentre and comparative study was performed. Lipid profile and cardiovascular risk criteria were determined according ATP-III. Cardiovascular risk was calculated trough Framingham equation. Patients with a cardiovascular risk at 10 years over 10% were considered of high risk. When p value was lower than 0.05, it was considered statistically significant between both groups.
Results: 256 HIV-infected adults patient were studied, 207 receiving HAART (group 1) and 49 without it (group 2). Prevalence of cardiovascular risk at 10 years above 10% was of 16% in patients of group 1, and of 12% in group 2. Average value calculated with Framingham equation was higher in group 1 (6.6 ± 5.6% vs 5.2 ± 5.0%, p = 0.02). Variables statistically meaningful for cardiovascular risk at 10 years above 10% were: smoking, age, male gender and non-HDL cholesterol.
Conclusions: Prevalence of cardiovascular risk at 10 years higher than 10% was similar in both groups. Nevertheless, average of cardiovascular risk at 10 years was higher in group 1. Risk factors were: smoking, male gender in subjects over 45 years old and non-HDL cholesterol. Framingham equation could be a useful tool that will require more extensive studies to validate in this population group.


REFERENCES

  1. Patella FJ, Delaney KM, Moorman AC. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med 1998;338:853-60.

  2. Carr A, Samaras K, Burton S, Law M, et al. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS 1998;12: F51-F58.

  3. Dong KL, Bausserman LL, Flynn MM. Changes in body habitus and serum lipid abnormalities in HIV-positive women on highly active antiretroviral therapy (HAART). J Acquir Immune Defic Syndr Hum Retrovirol 1991;21:107-33.

  4. Castro-Sansores CJ, Santos-Rivero A, Lara-Perera D, González- Martínez P, et al. Hiperlipidemia e intolerancia a la glucosa en un grupo de pacientes infectados con VIH que reciben terapia antirretrovírica hiperactiva. Sal Pub Mex 2006;48:193-9.

  5. Hoyert DL, Arias E, Smith BL, Murphy SL, Kochanek KD. Deaths: final data for 1999. National Vital Statistics Reports 2001;49:1-134.

  6. The Data Collection on Adverse Events of Anti-HIV Drugs (DAD) Study Group. Combination of antiretroviral therapy and the risk of myocardial infarction. N Engl J Med 2003;349:1993- 2003.

  7. Bergersen BM, Sandvik L, Bruun JN, Tonstad S. Elevated Framingham risk score in HIV-positive patients on highly active antiretroviral therapy: results from a Norwegian study of 721 subjects. Eur J Clin Microbiol Infect Dis 2004;23:625-30.

  8. Santos J, Palacios R, González M, Ruiz J, Márquez M. Atherogenic lipid profile and cardiovascular risk factors in HIV-infected patients (Netar Study). International Journal of STD & AIDS 2005;16:677-80.

  9. Savès SM, Chêne G, Ducimetière P, Leport C, et al. Risk factors for coronary heart disease in patients treated for human immunodeficiency virus infection compared with the general population. Clin Infect Dis 2003;37:292-8.

  10. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97.

  11. Wilson PWF, D’Agostino RB, Levy D, Belanger AM, et al. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97;1837-47.

  12. Hadigan C, Meigs JB, Wilson PWF, D’Agostino RB, et al. Prediction of coronary heart disease risk in HIV-infected patients with fat redistribution. Clin Infect Dis 2003;36:909-16.

  13. Glass TR, Ungsedhapand C, Battegar M, Weber R, et al. Prevalence of cardiovascular risk factors in HIV-infected individuals: the Swiss HIV Cohort Study. Program and Abstracts of the XV International AIDS Conference, Bangkok, Tai. 11-16 july, 2004. Abstract: WePeB5878.

  14. Chang KH, Kim JM, Song YG, Hong SK, et al. Does race protect an oriental population from developing lipodystrophy in HIV-infected individuals on HAART? J Infect 2002;44:33-38.

  15. Cui Y, Blumenthal RS, Flaws JA, Whiteman MK, et al. Nonhigh- density lipoprotein cholesterol level as a predictor of cardiovascular disease mortality. Arch Intern Med 2001;161:1413- 19.

  16. Pischon T, Girman CJ, Sacks FM, Rifai N, et al. Non-hig density lipoprotein cholesterol and apolipoprotein B in the prediction of coronary heart disease in men. Circulation 2005;112:3375-83.




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