Low CD4+ T-cell count as a major atherosclerosis risk factor in HIV-infected women and men

Robert C. Kaplan, Lawrence A. Kingsley, Stephen J Gange, Lorie Benning, Lisa Paula Jacobson, Jason Lazar, Kathryn Anastos, Phyllis C. Tien, A. Richey Sharrett, Howard N. Hodis

Research output: Contribution to journalArticle

Abstract

Objective:: To assess the association of HIV infection, HIV disease parameters (including CD4+ T-cell counts, HIV viral load, and AIDS) and antiretroviral medication use with subclinical carotid artery atherosclerosis. Design:: Cross-sectional study nested within a prospective cohort study. Methods:: Among participants in the Womens Interagency HIV Study (1331 HIV-infected women, 534 HIV-uninfected women) and Multicenter AIDS Cohort Study (600 HIV-infected men, 325 HIV-uninfected men), we measured subclinical carotid artery lesions and common carotid artery intima-media thickness using B-mode ultrasound. We estimated adjusted mean carotid artery intima-media thickness differences and prevalence ratios for carotid lesions associated with HIV-related disease and treatments, with multivariate adjustment to control for possible confounding variables. Results:: Among HIV-infected individuals, a low CD4+ T-cell count was independently associated with an increased prevalence of carotid lesions. Compared with the reference group of HIV-uninfected individuals, the adjusted prevalence ratio for lesions among HIV-infected individuals with CD4+ T-cell count less than 200 cells/μl was 2.00 (95% confidence interval, 1.22ĝ€"3.28) in women and 1.74 (95% confidence interval, 1.04ĝ€"2.93) in men. No consistent association of antiretroviral medications with carotid atherosclerosis was observed, except for a borderline significant association between protease inhibitor use and carotid lesions in men (with no association among women). History of clinical AIDS and HIV viral load were not significantly associated with carotid atherosclerosis. Conclusion:: Beyond traditional cardiovascular disease risk factors, low CD4+ T-cell count is the most robust risk factor for increased subclinical carotid atherosclerosis in HIV-infected women and men.

Original languageEnglish (US)
Pages (from-to)1615-1624
Number of pages10
JournalAIDS
Volume22
Issue number13
DOIs
StatePublished - Aug 20 2008

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CD4 Lymphocyte Count
Atherosclerosis
HIV
T-Lymphocytes
Carotid Artery Diseases
Carotid Arteries
Carotid Intima-Media Thickness
Acquired Immunodeficiency Syndrome
Viral Load
Cohort Studies
Confidence Intervals
Confounding Factors (Epidemiology)
Common Carotid Artery
Protease Inhibitors
HIV Infections
Cardiovascular Diseases
Cross-Sectional Studies
Prospective Studies

Keywords

  • AIDS
  • Carotid arteries
  • Epidemiology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases
  • Medicine(all)

Cite this

Low CD4+ T-cell count as a major atherosclerosis risk factor in HIV-infected women and men. / Kaplan, Robert C.; Kingsley, Lawrence A.; Gange, Stephen J; Benning, Lorie; Jacobson, Lisa Paula; Lazar, Jason; Anastos, Kathryn; Tien, Phyllis C.; Sharrett, A. Richey; Hodis, Howard N.

In: AIDS, Vol. 22, No. 13, 20.08.2008, p. 1615-1624.

Research output: Contribution to journalArticle

Kaplan, RC, Kingsley, LA, Gange, SJ, Benning, L, Jacobson, LP, Lazar, J, Anastos, K, Tien, PC, Sharrett, AR & Hodis, HN 2008, 'Low CD4+ T-cell count as a major atherosclerosis risk factor in HIV-infected women and men', AIDS, vol. 22, no. 13, pp. 1615-1624. https://doi.org/10.1097/QAD.0b013e328300581d
Kaplan, Robert C. ; Kingsley, Lawrence A. ; Gange, Stephen J ; Benning, Lorie ; Jacobson, Lisa Paula ; Lazar, Jason ; Anastos, Kathryn ; Tien, Phyllis C. ; Sharrett, A. Richey ; Hodis, Howard N. / Low CD4+ T-cell count as a major atherosclerosis risk factor in HIV-infected women and men. In: AIDS. 2008 ; Vol. 22, No. 13. pp. 1615-1624.
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T1 - Low CD4+ T-cell count as a major atherosclerosis risk factor in HIV-infected women and men

AU - Kaplan, Robert C.

AU - Kingsley, Lawrence A.

AU - Gange, Stephen J

AU - Benning, Lorie

AU - Jacobson, Lisa Paula

AU - Lazar, Jason

AU - Anastos, Kathryn

AU - Tien, Phyllis C.

AU - Sharrett, A. Richey

AU - Hodis, Howard N.

PY - 2008/8/20

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N2 - Objective:: To assess the association of HIV infection, HIV disease parameters (including CD4+ T-cell counts, HIV viral load, and AIDS) and antiretroviral medication use with subclinical carotid artery atherosclerosis. Design:: Cross-sectional study nested within a prospective cohort study. Methods:: Among participants in the Womens Interagency HIV Study (1331 HIV-infected women, 534 HIV-uninfected women) and Multicenter AIDS Cohort Study (600 HIV-infected men, 325 HIV-uninfected men), we measured subclinical carotid artery lesions and common carotid artery intima-media thickness using B-mode ultrasound. We estimated adjusted mean carotid artery intima-media thickness differences and prevalence ratios for carotid lesions associated with HIV-related disease and treatments, with multivariate adjustment to control for possible confounding variables. Results:: Among HIV-infected individuals, a low CD4+ T-cell count was independently associated with an increased prevalence of carotid lesions. Compared with the reference group of HIV-uninfected individuals, the adjusted prevalence ratio for lesions among HIV-infected individuals with CD4+ T-cell count less than 200 cells/μl was 2.00 (95% confidence interval, 1.22ĝ€"3.28) in women and 1.74 (95% confidence interval, 1.04ĝ€"2.93) in men. No consistent association of antiretroviral medications with carotid atherosclerosis was observed, except for a borderline significant association between protease inhibitor use and carotid lesions in men (with no association among women). History of clinical AIDS and HIV viral load were not significantly associated with carotid atherosclerosis. Conclusion:: Beyond traditional cardiovascular disease risk factors, low CD4+ T-cell count is the most robust risk factor for increased subclinical carotid atherosclerosis in HIV-infected women and men.

AB - Objective:: To assess the association of HIV infection, HIV disease parameters (including CD4+ T-cell counts, HIV viral load, and AIDS) and antiretroviral medication use with subclinical carotid artery atherosclerosis. Design:: Cross-sectional study nested within a prospective cohort study. Methods:: Among participants in the Womens Interagency HIV Study (1331 HIV-infected women, 534 HIV-uninfected women) and Multicenter AIDS Cohort Study (600 HIV-infected men, 325 HIV-uninfected men), we measured subclinical carotid artery lesions and common carotid artery intima-media thickness using B-mode ultrasound. We estimated adjusted mean carotid artery intima-media thickness differences and prevalence ratios for carotid lesions associated with HIV-related disease and treatments, with multivariate adjustment to control for possible confounding variables. Results:: Among HIV-infected individuals, a low CD4+ T-cell count was independently associated with an increased prevalence of carotid lesions. Compared with the reference group of HIV-uninfected individuals, the adjusted prevalence ratio for lesions among HIV-infected individuals with CD4+ T-cell count less than 200 cells/μl was 2.00 (95% confidence interval, 1.22ĝ€"3.28) in women and 1.74 (95% confidence interval, 1.04ĝ€"2.93) in men. No consistent association of antiretroviral medications with carotid atherosclerosis was observed, except for a borderline significant association between protease inhibitor use and carotid lesions in men (with no association among women). History of clinical AIDS and HIV viral load were not significantly associated with carotid atherosclerosis. Conclusion:: Beyond traditional cardiovascular disease risk factors, low CD4+ T-cell count is the most robust risk factor for increased subclinical carotid atherosclerosis in HIV-infected women and men.

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KW - Epidemiology

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