Aterosclerose em indivíduos infectados com o HIV

Abstract

Objective: To compare the measurements of the ankle-arm index and the intima-media complex of the femoral and subclavian carotids in patients with HIV on antiretroviral therapy in relation to the Control Group. Methods: Seventy patients with HIV who had been on antiretroviral therapy for at least five years and 70 individuals who are not infected with HIV, paired by gender and age, aged until 50 years, were assessed by the measurement of the ankle-arm index and the intima-media complex of the common, internal, femoral and right subclavian carotids. In common carotids, the manual and automatic measurement of the intima-media complex were perform, and the automatic measurement of the common carotid was considered as the gold standard, regarding the thick intima-media complex when it is >0.8 mm. The group homogeneity was analyzed at a 5% significance level, and automatic and manual measurements were compared; for the carotids, Bland-Altman graphs were used. Results: A patient from the case group (0.7%) presented an increased ankle-arm index (>1.3 bilaterally with no signs of calcification), and no changes were observed in the control group. The automatic average of the intima-media complex in common carotids was not thick in any individual. There was no significant different between the groups as to the ankle-arm index, the intima-media complex and the presence of atheromatous plaques. Mean age was 40.5 years in the case group, and 40.8 years in the control group. Both groups were similar as to smoking and systemic arterial hypertension. Cholesterol and triglycerides were higher in the case group, but the body mass index and the abdominal circumference had a higher normality percentage in this group. When comparing the automatic average right common carotid (RCC) with other locations (subclavian origin, medium segment and common femoral), the difference was statistically and clinically significant in the origin of the right subclavian (RCC=0.51 versus 0.91 mm; p<0.001). Conclusion: People who have HIV do not present a higher risk for atherosclerosis than the control population, considering the classic risk factors of atherosclerosis and the specific characteristics of the HIV. By comparing the automatic average of RCC with other locations, the difference was statistically and clinically significant in the origin of the right subclaian.