Ankle-branch index and HIV: The role of antiretrovirals

Abstract

Objective: To study the relationship between antiretroviral (ARV) treatment and abnormal ankle-branch index (ABI) and to compare the risk factors for altered ABI. Methods: Patients coming to the office from April 2007 until July 2007 were offered the chance to take part in the study. ABI was obtained by the standard technique. Those ≤0.9 or ≥1.3 were considered altered ABI. Clinical reports were reviewed to examine traditional vascular risk factors, coinfection with hepatitis C virus and/or hepatitis B virus, tobacco use, highly active antiretroviral therapy use and its components and length of use of each ARV drug. Results: ABI was measured in 147 patients, 82.3% males. Thirty-three patients (22.45%) had an altered ABI, and it was related to CD4 cell nadir, dyslipidaemia and protease inhibitor (PI) use. When logistic regression was carried out, only dyslipidaemia (OR 2.68, CI 95%: 1.06-6.91) and PI use (OR 2.79, CI 95%: 1.15-6.54) remained in the model. Conclusions: Altered ABI is associated with PI use independently of dyslipidaemia. Probably, it marks patients with high vascular risk not identified with traditional scales. © 2009 British HIV Association.