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Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men
- Source :
- AIDS (London, England), vol 32, iss 16
- Publication Year :
- 2018
- Publisher :
- eScholarship, University of California, 2018.
-
Abstract
- ObjectiveAmong people with HIV, there are few long-term studies of noninvasive ultrasound-based measurements of the carotid artery predicting major health events. We hypothesized that such measurements are associated with 10-year mortality in the Women's Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS), and that associations differ by HIV serostatus.DesignNested cohort study.MethodsParticipants without coronary heart disease underwent B-mode carotid artery ultrasound, with measurement of common carotid artery intima-media thickness (IMT); carotid artery plaque (focal IMT > 1.5 mm) at six locations; and Young's modulus of elasticity, a measure of arterial stiffness. We examined all-cause mortality using Cox models, controlling for demographic, behavioral, cardiometabolic, and HIV-related factors.ResultsAmong 1722 women (median age 40 years, 90% nonwhite, 71% HIV-positive) and 1304 men (median age 50, 39% nonwhite, 62% HIV-positive), 11% died during follow-up. Mortality was higher among HIV-positive women [19.9 deaths/1000 person-years, 95% confidence interval (CI) 14.7-28.8] than HIV-positive men (15.1/1000, 95% CI 8.3-26.8). In adjusted analyses, plaque was associated with mortality (hazard ratio 1.44, 95% CI 1.10-1.88) regardless of HIV serostatus, and varied by sex (among women, hazard ratio 1.06, 95% CI 0.74-1.52; among men; hazard ratio 2.19, 95% CI 1.41-3.43). The association of plaque with mortality was more pronounced among HIV-negative (hazard ratio 3.87, 95% 1.95-7.66) than HIV-positive participants (hazard ratio 1.35, 95% CI 1.00-1.84). Arterial stiffness was also associated with mortality (hazard ratio 1.43 for highest versus lowest quartile, 95% CI 1.02-2.01). Greater common carotid artery-IMT was not associated with mortality.ConclusionCarotid artery plaque was predictive of mortality, with differences observed by sex and HIV serostatus.
- Subjects :
- Adult
Male
Aging
HIV Infections
Cardiovascular
Carotid Intima-Media Thickness
Medical and Health Sciences
Cohort Studies
plaque
Clinical Research
Virology
Behavioral and Social Science
Humans
Carotid Stenosis
intima-media thickness
screening and diagnosis
Prevention
Psychology and Cognitive Sciences
HIV
Middle Aged
Biological Sciences
Prognosis
Atherosclerosis
Survival Analysis
mortality
Detection
Carotid Arteries
Heart Disease
Good Health and Well Being
arterial stiffness
HIV/AIDS
Female
4.2 Evaluation of markers and technologies
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- AIDS (London, England), vol 32, iss 16
- Accession number :
- edsair.od.......325..b6a1bcf65dc88b4b16f702e7c2e7efbd