Vascular Health and Risk Management (Sep 2024)

Cardiovascular Risk in People Living with Human Immunodeficiency (HIV) Viremia Suppression in a Young, Mid-Eastern European Population - Preliminary Study

  • Jachymek M,
  • Wójcik Ł,
  • Peregud-Pogorzelska M,
  • Parczewski M,
  • Dembowska A,
  • Aksak-Wąs BJ

Journal volume & issue
Vol. Volume 20
pp. 435 – 445

Abstract

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Magdalena Jachymek,1 Łukasz Wójcik,2 Małgorzata Peregud-Pogorzelska,1 Miłosz Parczewski,3 Aneta Dembowska,3 Bogusz Jan Aksak-Wąs3 1Department of Cardiology, Pomeranian Medical University, Szczecin, 70-111, Poland; 2Department of Radiology, Pomeranian Medical University, Szczecin, 70-111, Poland; 3Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, 71-455, PolandCorrespondence: Bogusz Jan Aksak-Wąs, Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, 71-455, Poland, Email [email protected]: People living with HIV are twice as likely to develop cardiovascular diseases (CVDs) and myocardial infarction related to atherosclerosis than the uninfected population. This study aimed to evaluate the prevalence of subclinical atherosclerosis in a young, mid-eastern European population of PLWH receiving ART for undetectable viremia.Patients and Methods: This was a single-centre study. We included 34 patients below 50 years old, treated in Szczecin, Poland, with confirmed HIV-1 infection, treated with antiretroviral therapy (ART), and undetectable viremia. All patients underwent coronary artery computed tomography (CACT), carotid artery intima-media thickness (IMT) evaluation, and echocardiography.Results: In the primary assessment, only two (5.8%) patients had an increased CVD risk calculated using the Framingham Risk Score (FRS), but we identified coronary or carotid plaques in 26.5% of the patients. Neither traditional risk factors nor those associated with HIV significantly influenced the presence of the plaque. IMT was significantly positively correlated with age and the FRS (R=0.38, p=0.04). Relative wall thickness assessed in echocardiography was higher in those with plaque (0.49 vs 0.44, p=0.04) and significantly correlated with IMT (R=0.38, p=0.04).Conclusion: In our population, more than a quarter of PLWH with undetectable viremia had subclinical atherosclerosis in either the coronary or carotid arteries. The FRS underpredicted atherosclerosis in this population. The role of RWT as a possible early marker of atherosclerosis needs further studies.Keywords: cardiovascular disease, echocardiography, coronary artery computed tomography, intima media thickness, people living with human immunodeficiency virus

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