Frequency of Subclinical Atherosclerosis in HIV-infected Brazilians

The advances in the treatment of the Human Immunodeficiency Virus (HIV) infection have resulted in a significant reduction in the mortality related to the acquired immunodeficiency syndrome (AIDS). Most patients get infected between the ages of 19 and 39 years, receive medicines from the time of diagnosis onward, with no perspective of interruption. In the follow-up of those patients, chronic non-infectious diseases related to several risk factors, such as age and cardiovascular disease, emerge. Some studies have shown the direct action of the HIV on the vascular endothelium (chronic inflammatory process), in addition to the action of the antiretroviral therapy (ART) on the lipid metabolism.

The incidence of cardiovascular events among HIV-infected patients is low, being, thus, difficult to assess. Subclinical atherosclerosis is associated with an increased risk for events in the general population. It can be detected by use of non-invasive methods, such as carotid ultrasound, aimed at measuring the intimal medial thickness and at assessing the presence of atherosclerotic plaque, in addition to coronary computed tomography to calculate the calcium score. Coronary tomography angiography allows the assessment of the presence, composition and extension of coronary plaques, in addition to detecting stenosis.

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