TY - JOUR

T1 - High incidence of subclinical peripheral artery disease in people with HIV

AU - Suarez-Zdunek, Moises Alberto

AU - Høgh, Julie

AU - Kirkegaard-Klitbo, Ditte Marie

AU - Jensen, Anne Marie R.

AU - Rupert, Adam

AU - Trøseid, Marius

AU - Gerstoft, Jan

AU - Nielsen, Susanne D.

AU - Knudsen, Andreas D.

N1 - Publisher Copyright: Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

PY - 2022

Y1 - 2022

N2 - Objective:Atherosclerosis is common in people with HIV (PWH). Peripheral artery disease (PAD) is the peripheral manifestation of atherosclerosis, but little is known about the incidence of PAD in PWH. Our objective was to determine the PAD incidence in PWH and to investigate potential risk factors.Design:Prospective longitudinal study on PWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) study cohort.Methods:We performed ankle-brachial index (ABI) measurements at study entry and at 2-year follow-up and included participants with normal ABI at study entry. We defined de novo PAD as ABI ≤0.9 at follow-up. Using Poisson regression adjusted for age, sex, and smoking, we investigated the role of traditional and HIV-related risk factors, including inflammatory markers.Results:Of 844 PWH followed for a median duration of 2.3 years, 30 (3.6%) developed de novo PAD. All cases were subclinical. Diabetes (relative risk [RR] = 4.90 [95% confidence interval [CI]: 1.99-12.1]), current CD4+ cell count <350 cells/μl (2.66 [1.06-6.71]), longer duration of antiretroviral therapy (antiretroviral therapy [ART], 1.88 [1.06-3.33] per decade), and concentrations of high-sensitivity C-reactive protein (1.33 [1.08-1.63] per doubling) and interleukin-6 (1.38 [1.06-1.80] per doubling), were associated with de novo PAD.Conclusions:PWH had a high incidence of de novo subclinical PAD. Diabetes, low current CD4+ cell count, duration of ART, and inflammatory markers were associated with de novo PAD, indicating a possible role in PAD pathogenesis in PWH.

AB - Objective:Atherosclerosis is common in people with HIV (PWH). Peripheral artery disease (PAD) is the peripheral manifestation of atherosclerosis, but little is known about the incidence of PAD in PWH. Our objective was to determine the PAD incidence in PWH and to investigate potential risk factors.Design:Prospective longitudinal study on PWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) study cohort.Methods:We performed ankle-brachial index (ABI) measurements at study entry and at 2-year follow-up and included participants with normal ABI at study entry. We defined de novo PAD as ABI ≤0.9 at follow-up. Using Poisson regression adjusted for age, sex, and smoking, we investigated the role of traditional and HIV-related risk factors, including inflammatory markers.Results:Of 844 PWH followed for a median duration of 2.3 years, 30 (3.6%) developed de novo PAD. All cases were subclinical. Diabetes (relative risk [RR] = 4.90 [95% confidence interval [CI]: 1.99-12.1]), current CD4+ cell count <350 cells/μl (2.66 [1.06-6.71]), longer duration of antiretroviral therapy (antiretroviral therapy [ART], 1.88 [1.06-3.33] per decade), and concentrations of high-sensitivity C-reactive protein (1.33 [1.08-1.63] per doubling) and interleukin-6 (1.38 [1.06-1.80] per doubling), were associated with de novo PAD.Conclusions:PWH had a high incidence of de novo subclinical PAD. Diabetes, low current CD4+ cell count, duration of ART, and inflammatory markers were associated with de novo PAD, indicating a possible role in PAD pathogenesis in PWH.

KW - ankle-brachial index

KW - combination antiretroviral therapy

KW - HIV

KW - inflammation mediators

KW - peripheral arterial disease

U2 - 10.1097/QAD.0000000000003252

DO - 10.1097/QAD.0000000000003252

M3 - Journal article

C2 - 35608109

AN - SCOPUS:85135282488

VL - 36

SP - 1355

EP - 1362

JO - AIDS

JF - AIDS

SN - 1350-2840

IS - 10

ER -