Asymptomatic peripheral arterial disease detected by the ankle-brachial index in HIV-infected patients: prevalence and associated risk factors

作者：C****ejo Eduardo^*; Cabello Noemi; Perales Isabel; Anodi Sonia; Sanchez Purificacion Aquilino

来源：Enfermedades Infecciosas y Microbiologia Clinica, 2011, 29(9): 672-678.

DOI：10.1016/j.eimc.2011.07.006

• HIV
• Peripheral arterial disease
• Ankle-brachial index
• Cardiovascular risk

Introduction: Human immunodeficiency virus (HIV) infection has been associated with a higher risk of subclinical atherosclerosis and cardiovascular events. Peripheral arterial disease (PAD) is a good marker of systemic atherosclerosis and a powerful predictor of cardiovascular morbidity and mortality. The objective of this study was to determine the prevalence of asymptomatic PAD and associated risk factors in HIV-infected people.
Methods: Cross-sectional study was conducted on all consecutive HIV-positive patients older than 20 years without symptoms of intermittent claudication who attended our clinic between November 2008 and December 2009. PAD was assessed by measuring the ankle-brachial index (ABI) at rest. To define PAD, an ABI <= 0.90 was used. Main epidemiological and clinical characteristics of the HIV infection and cardiovascular risk factors (CVRF) were recorded.
Results: Two hundred and five patients were evaluated (66.8% male), with a mean age of 41 years and there was a median of 2 CVRF (63.9% smokers). Prevalence of asymptomatic PAD (ABI <= 0.90) was 6.3% (n = 13). There was only 1 patient with a high ABI (> 1.40). In the multivariate analysis, factors significantly associated with PAD were overweight (adjusted odds ratio [ORadj] 4.21; 95% confidence interval [CI] 1.00-18.78), obesity (ORadj 5.76; 95% CI 1.17-28.37) and clinical stage C of HIV infection (ORadj 2.95; 95% CI 1.00-9.83).
Conclusions: Prevalence of asymptomatic PAD in a relatively young HIV-infected cohort is similar to that observed in the uninfected middle-aged adult population. Overweight, obesity and advanced clinical stage of HIV infection (AIDS-defining conditions) were identified as independent risk factors for PAD.

• 出版日期2011-11