Journal sur le SIDA et la recherche clinique

Abdominal Aortic Calcification in Patient's Infected by the Human Immunodeficiency Virus

Abstract

Meriem Sarah Mekki, Sophie Liabeuf, Julien Paccou, Thierry Izet, Cedric Renard, Ziad A Massy and Jean Luc Schmit

In countries where highly active antiretroviral therapy (HAART) is available, cardiovascular disease is a major cause of morbidity and mortality in patients infected by the human immunodeficiency virus (HIV). Vascular calcification is used as subclinical marker of atherosclerosis. As vascular calcification is now considered to be an active, inflammatory process, its evaluation in HIV-infected patients may thus be clinically relevant. The primary objective of the present study was to determine and compare the prevalence of abdominal aortic calcification (using the multislice spiral computed tomography) in HIV-positive patients receiving HAART and in HIV-negative control subjects. The secondary objective was to determine the risk factors associated with the presence of abdominal aortic calcification in HIV-positive patients. Seventy-seven HIV-positive patients and 77 HIV-negative controls were included in the study. We found that the prevalence of abdominal aortic calcification was similar in the two groups. Furthermore, the mean abdominal aortic calcification score was not significantly higher in HIV-positive patients than in controls. The following parameters were correlated with the aortic calcification score: age (p<0.0001), total cholesterol (p=0.004), low density lipoprotein cholesterol (p=0.007), estimated creatinine clearance (p=0.039), low viral load (p=0.02) and time since the diagnosis of HIV infection (p=0.005). However, in a multivariate analysis, only age was independently associated with the aortic calcification score (p=0.007). In conclusion, abdominal aortic calcification is neither more frequent nor more severe in HIV-positive patients than in HIV-negative controls, and seems only to be affected by independent HIV factors (such as age) in the patients. It remains to be established whether the progression of abdominal aortic calcification is independent of HIV status (in contrast to what has been observed for coronary calcification).