Journal Article

High Prevalence of Peripheral Arterial Disease in HIV-Infected Persons

Daniel Periard, Matthias Cavassini, Patrick Taffé, Melanie Chevalley, Laurence Senn, Caroline Chapuis-Taillard, Serge de Vallière, Daniel Hayoz and Philip E. Tarr

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 46, issue 5, pages 761-767
Published in print March 2008 | ISSN: 1058-4838
Published online March 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/527564
High Prevalence of Peripheral Arterial Disease in HIV-Infected Persons

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Background. Atherosclerosis has been assessed in human immunodeficiency virus (HIV)-infected persons by using various methods. Peripheral arterial disease (PAD) has not been evaluated, however. We studied the cross-sectional prevalence of lower limb PAD in an HIV-infected population.

Methods. PAD was assessed using the Edinburgh Claudication Questionnaire and by measuring the systolic ankle-brachial blood pressure index (ABI) at rest and after exercise. Patients with PAD were further evaluated by duplex scan of lower limb arteries.

Results. Ninety-two consecutive HIV-infected patients were evaluated (23.9% women; mean age, 49.5 years; 61.9% current smokers). Claudication was reported by 15.2% of the patients. PAD was found in 20.7% of the patients: 9.8% had an abnormal ABI (<0.90) at rest, and 10.9% had normal ABI at rest but a >25% decrease after exercise. Of the patients with PAD, 84.2% were investigated with duplex scan, all of whom had atherosclerotic occlusions or stenoses of the iliac or femoral arteries. Age, diabetes, smoking, and low CD4+ T lymphocyte counts were identified as independent predictors of PAD.

Conclusions. The prevalence of symptomatic and asymptomatic PAD is high in the HIV-infected population and is much higher than expected (prevalence in the general population, ∼3% at 60 years). This study suggests the presence of an epidemic of PAD ∼20 years earlier in the HIV-infected than in the general population. Larger epidemiological studies are needed to better define risk factors and to evaluate whether PAD is associated with increased mortality, as it is in the general population.

Journal Article.  4305 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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