Treated HIV Infection and Progression of Carotid Atherosclerosis in Rural Uganda: A Prospective Observational Cohort Study.

Auteurs: Siedner MJ Bibangambah P Kim JH Lankowski A Chang JL Yang IT Kwon DS North CM Triant VA Longenecker C Ghoshhajra B Peck RN Sentongo RN Gilbert R Kakuhikire B Boum Y Haberer JE Martin JN Tracy R Hunt PW Bangsberg DR Tsai AC Hemphill LC Okello S
Référence de l'article: Journal of the American Heart Association 2021 Jun 05; (); e019994. doi: 10.1161/JAHA.120.019994. Epub 2021 06 05
HIV infection Uganda antiretroviral therapy atherosclerosis cardiovascular disease risk carotid intima media thickness


Background Although ≈70% of the world's population of people living with HIV reside in sub-Saharan Africa, there are minimal prospective data on the contributions of HIV infection to atherosclerosis in the region. Methods and Results We conducted a prospective observational cohort study of people living with HIV on antiretroviral therapy >40 years of age in rural Uganda, along with population-based comparators not infected with HIV. We collected data on cardiovascular disease risk factors and carotid ultrasound measurements annually. We fitted linear mixed effects models, adjusted for cardiovascular disease risk factors, to estimate the association between HIV serostatus and progression of carotid intima media thickness (cIMT). We enrolled 155 people living with HIV and 154 individuals not infected with HIV and collected cIMT images at 1045 visits during a median of 4 annual visits per participant (interquartile range 3-4, range 1-5). Age (median 50.9 years) and sex (49% female) were similar by HIV serostatus. At enrollment, there was no difference in mean cIMT by HIV serostatus (0.665 versus 0.680 mm, =0.15). In multivariable models, increasing age, blood pressure, and non-high-density lipoprotein cholesterol were associated with greater cIMT (