The Prevalence of PAD in HIV Patients

Abstract

PURPOSE: Peripheral Arterial Disease (PAD) is a focal manifestation of atherosclerosis and is a predictor of cardiovascular outcomes. Human Immunodeficiency Virus (HIV) has been associated with premature atherosclerosis, but prevalence of PAD in these patients is not well defined. The objective of this study is to determine the prevalence of PAD in HIV patients. METHOD(S): 204 patients were consecutively enrolled from January 2009 to September 2009 [70 in HIV group and 134 in non HIV control group (age and sex matched)]. The mean age was 50 years. The Edinburg Claudication Questionnaire and Ankle Brachial Index (ABI) were used as study tools. Normal ABI was defined as 0.9 to 1.3. Data were analyzed using the Fischer Exact Test. Various risk factors for PAD were also analyzed. RESULT(S): Abnormal ABI (< 0.9, >1.3) was found in 24.3% (17/70) of HIV patients as compared to 10% (17/134) in non HIV controls (P value 0.04). ABI < 0.9 was reported in 10.0% (7/70) of HIV patients as compared to 1.5% (2/134) in non-HIV controls (P value 0.008). Age, Smoking, low HDL and low CD4 counts were identified as independent predictors of PAD in HIV patients. CONCLUSION(S): The prevalence of PAD is higher in patients with HIV as compared to matched non-HIV controls based on ABI measurement. The prevalence of PAD was proportionally related to the severity of HIV infection (low CD4 count). CLINICAL IMPLICATIONS: Non-invasive screening tests like ABI have an important role in diagnosis of asymptomatic HIV patients with PAD. It may warrant risk factor modifications and aggressive medical therapy to reduce the progression of this disease.