Curr Health Sci J, vol. 39, no. 2, 2013

Markers of subclinical atherosclerosis and cardiovascular risk in young adults horizontally infected with HIV-1 during infancy

[Original Paper]

FLORENTINA DUMITRESCU1, A CUPSA1, DINA-MARIA CUPSA2, DANIELA MARINESCU3, ANDREEA CRISTINA STOIAN1, L GIUBELAN1, IRINA NICULESCU 1, CRISTINA IOCU 2

1 University of Medicine and Pharmacy, Craiova, Infectious Diseases Department, 2“Victor Babes” Hospital of Infectious Diseases and Pneumology, Craiova, 3Emergency Clinical Hospital Craiova


Abstract:

Objectives: to evaluate the markers of subclinical atherosclerosis and to identify a potential cardiovascular risk (CVR) profile in young adults horizontally infected with HIV-1 during infancy. Methods: prospective randomized study, carried out between 01 January 2010 and 30 June 2010, on 56 HIV infected persons (PIH) parenterally infected with HIV-1 during 1988-1990, following antiretroviral treatment (ART), under surveillance of Craiova HIV/AIDS Regional Center, Romania. Variables followed: personal history and clinical data, traditional and additional CVR factors, metabolic, immunological and virological parameters, inflammation markers (high-sensitivity C reactive proteine- hs-CRP), ultrasound data regarding carotid intima-media thickness (IMT). Twenty-six HIV-seronegative young adults were assigned as control group (CG) for metabolic parameters, hs-CRP and IMT. Results: general characteristics of the group: average age = 20.82 ± 1.1 years, equal gender distribution, 47 PIH (83.93%) classified as clinical and/or immunological AIDS, 26 PIH (46.43%) with CD4>500/mm3, 40 PIH (71.43%) with undetectable RNA-HIV when evaluated, average ART duration = 9.09 ± 3.2 years, average number of ART regimens = 3.2 ± 1.63, 40 PIH (71.43%) experienced to protease inhibitors (PIs). In PIH – hs-CRP = 2.17 mg/l, equivalent with a moderate CVR, statistically different compared with CG (p<0.0001); IMT = 0.76 ± 0.12 mm in PIH vs 0.6 ± 0.11 mm in CG. From the traditional CVR factors dyslipidemia levels were higher in the PIH group vs CG (p<0.0001). In PIH, linear analysis of the evaluated parameters identified direct correlations between hs-CRP- erythrocytes sedimentation rate (ESR) (p=0.04), number of ART regimens and PIs exposure (p=0.007), IMT (p=0.000) and HIV-RNA (p=0.000) and also between IMT–triglycerides (p=0.004), PIs exposure (p=0.004), CD8+ (p=0.0000) and HIV-RNA (p=0.001). Conclusions: young PIH have had an average value of hs-CRP suggestive for a moderate CVR. Elevated triglycerides, ESR, CD8+, HIV-RNA values and long period of PIs exposure should be components of a CVR profile in young adult infected with HIV-1 during infancy.


Keywords:
HIV, young, atherosclerosis, cardiovascular risk



Corresponding:
Dumitrescu Florentina, MD, PhD, Infectious Diseases Department, University of Medicine and Pharmacy from Craiova, Petru Rares street, no. 2-4, RO-200349, Craiova, Dolj, Romania


DOI 10.12865/CHSJ.39.02.03 - Download PDF