AEGiS-13IAC: Relation between lipodystrophy and carotid intima-media thickness in HIV-1 infected patients.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Relation between lipodystrophy and carotid intima-media thickness in HIV-1 infected patients.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrB761)

Mercie P, Thiebaut R, Lavignole V, Morlat P, Malvy D, Dupon M, Ragnaud J-M, Dabis F
P. Mercie, Bordeaux University Hospital, Hospital Haut Leveque, 5 av de Magellan, 33604 Pessac, France, Tel.: +33 5 56 55 64 83, Fax: +33 5 56 55 64 84, E-mail: patrick.mercie@wanadoo.fr

OBJECTIVE: To study carotid intima-media thickness (IMT) in HIV-1 infected patients to assess the cardiovascular risk and its determinants with special attention to lipodystrophy (LD).

METHOD: Cross-sectionnal survey within the Aquitaine Cohort (southwestern France) in late 1999. Common (CCA) and bifurcation (BF) carotid artery IMT were measured by B-mode ultrasonography. Age, gender, Body Mass Index (BMI), Waist-to-Hip ratio (WHR), smoking habits, alcohol intake, physical activity, systolic blood pressure, triglycerides level, total / HDL cholesterol, ApoB/ApoA1, HOMA ratio, HIV transmission group, AIDS stage, CD4 cell count, plasma viral load, type of antiretroviral treatment, duration since the date of HIV diagnosis and presence of LD were documented. Linear models predicting average IMT measures were conducted using the above listed explanatory variables.

RESULTS: Among 439 patients enrolled, 129 have been analysed (mean age 42 years, 25% women and 86% treated with HAART). 55 (43%) presented one type of LD (3 fat accumulation alone, 24 lipoatrophy alone, 28 mixed syndrome). When LD was present, mean IMT was 0.59 mm for CCA (SD 0.12) and 0.66 mm for BF (SD 0.14) compared to 0.56 (SD 0.09) and 0.60 mm (SD 0.11) without LD (p = 0.11 and p = 0.005, respectively). In univariate analysis, increased age, BMI, WHR, systolic blood pressure, total/HDL cholesterol, ApoB/ApoA1 and LD were associated with increased CCA and BF IMTs. In multivariate analyses, age (+0.05 mm for 10 years older, p>0.001) and BMI (+0.008 mm for 1 kg/m2 higher, p = 0.003) remained significantly associated with CCA IMT. BF IMT, a sensitive measure of atherosclerosis, was no longer associated with LD in multivariate model in this preliminary analysis but univariate relation argues for its role of cardiovascular risk factor, beside well known determinants (age and BMI). Analysis of the overall sample will be reported.

Keywords: AEGIS, Tunica Media, Tunica Intima, HIV-1, Lipodystrophy, Carotid Artery, Common, Body Mass Index, Carotid Arteries, HIV Infections, Obesity, Lipoproteins, HDL Cholesterol, Arteriosclerosis, CD4 Lymphocyte Count, Viral Load, Antiretroviral Therapy, Highly Active, France, Human, Female
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ThOrB761