Prevalence of Peripheral Artery Disease Is Higher in Persons Living With HIV Compared With Uninfected Controls: Brief Report

Andreas D. Knudsen; Marco Gelpi; Shoaib Afzal; Andreas Ronit; Ashley Roen; Amanda Mocroft; Jens Lundgren; Børge Nordestgaard; Henrik Sillesen; Anne-Mette Lebech; Lars Køber; Klaus F Kofoed; Susanne D. Nielsen

doi:10.1097/QAI.0000000000001795

Prevalence of Peripheral Artery Disease Is Higher in Persons Living With HIV Compared With Uninfected Controls: Brief Report

Andreas D. Knudsen, Marco Gelpi, Shoaib Afzal, Andreas Ronit, Ashley Roen, Amanda Mocroft, Jens Lundgren, Børge Nordestgaard, Henrik Sillesen, Anne-Mette Lebech, Lars Køber, Klaus F Kofoed, Susanne D. Nielsen

8 Citations (Scopus)

Abstract

OBJECTIVE: Ankle-brachial index is an excellent tool for diagnosing peripheral artery disease (PAD). We aimed to determine the prevalence and risk factors for PAD in people living with HIV (PLWH) compared with uninfected controls. We hypothesized that prevalence of PAD would be higher among PLWH than among controls independent of traditional cardiovascular disease (CVD) risk factors.

METHODS: PLWH aged 40 years and older were recruited from the Copenhagen comorbidity in HIV infection (COCOMO) study. Sex- and age-matched uninfected controls were recruited from the Copenhagen General Population Study. We defined PAD as ankle-brachial index ≤0.9 and assessed risk factors for PAD using logistic regression adjusting for age, sex, smoking status, dyslipidemia, diabetes, hypertension, and high-sensitivity C-reactive protein.

RESULTS: Among 908 PLWH and 11,106 controls, PAD was detected in 112 [12% confidence interval: (95% 10 to 14)] and 623 [6% (95% 5 to 6)], respectively (P < 0.001), odds ratio = 2.4 (95% 1.9 to 2.9), and adjusted odds ratio = 1.8 (95% 1.3 to 2.3, P < 0.001). Traditional CVD risk factors, but not HIV-related variables, were associated with PAD. The strength of the association between PAD and HIV tended to be higher with older age (P = 0.052, adjusted test for interaction).

CONCLUSIONS: Prevalence of PAD is higher among PLWH compared with uninfected controls, especially among older persons, and remains so after adjusting for traditional CVD risk factors. Our findings expand the evidence base that PLWH have excess arterial disease to also include PAD. The exact biological mechanisms causing this excess risk remain to be elucidated. Until then, focus on management of modifiable traditional risk factors is important.

Original language	English
Journal	J A I D S
Volume	79
Issue number	3
Pages (from-to)	381-385
Number of pages	5
ISSN	1525-4135
DOIs	https://doi.org/10.1097/QAI.0000000000001795
Publication status	Published - 2018

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Knudsen, A. D., Gelpi, M., Afzal, S., Ronit, A., Roen, A., Mocroft, A., Lundgren, J., Nordestgaard, B., Sillesen, H., Lebech, A-M., Køber, L., Kofoed, K. F., & Nielsen, S. D. (2018). Prevalence of Peripheral Artery Disease Is Higher in Persons Living With HIV Compared With Uninfected Controls: Brief Report. J A I D S, 79(3), 381-385. https://doi.org/10.1097/QAI.0000000000001795

Knudsen, AD, Gelpi, M, Afzal, S, Ronit, A, Roen, A, Mocroft, A, Lundgren, J , Nordestgaard, B , Sillesen, H , Lebech, A-M , Køber, L , Kofoed, KF & Nielsen, SD 2018, 'Prevalence of Peripheral Artery Disease Is Higher in Persons Living With HIV Compared With Uninfected Controls: Brief Report', J A I D S, vol. 79, no. 3, pp. 381-385. https://doi.org/10.1097/QAI.0000000000001795

@article{eae31305ae084ee193a4404ceddc1772,

title = "Prevalence of Peripheral Artery Disease Is Higher in Persons Living With HIV Compared With Uninfected Controls: Brief Report",

abstract = "OBJECTIVE: Ankle-brachial index is an excellent tool for diagnosing peripheral artery disease (PAD). We aimed to determine the prevalence and risk factors for PAD in people living with HIV (PLWH) compared with uninfected controls. We hypothesized that prevalence of PAD would be higher among PLWH than among controls independent of traditional cardiovascular disease (CVD) risk factors.METHODS: PLWH aged 40 years and older were recruited from the Copenhagen comorbidity in HIV infection (COCOMO) study. Sex- and age-matched uninfected controls were recruited from the Copenhagen General Population Study. We defined PAD as ankle-brachial index ≤0.9 and assessed risk factors for PAD using logistic regression adjusting for age, sex, smoking status, dyslipidemia, diabetes, hypertension, and high-sensitivity C-reactive protein.RESULTS: Among 908 PLWH and 11,106 controls, PAD was detected in 112 [12% confidence interval: (95% 10 to 14)] and 623 [6% (95% 5 to 6)], respectively (P < 0.001), odds ratio = 2.4 (95% 1.9 to 2.9), and adjusted odds ratio = 1.8 (95% 1.3 to 2.3, P < 0.001). Traditional CVD risk factors, but not HIV-related variables, were associated with PAD. The strength of the association between PAD and HIV tended to be higher with older age (P = 0.052, adjusted test for interaction).CONCLUSIONS: Prevalence of PAD is higher among PLWH compared with uninfected controls, especially among older persons, and remains so after adjusting for traditional CVD risk factors. Our findings expand the evidence base that PLWH have excess arterial disease to also include PAD. The exact biological mechanisms causing this excess risk remain to be elucidated. Until then, focus on management of modifiable traditional risk factors is important.",

author = "Knudsen, {Andreas D.} and Marco Gelpi and Shoaib Afzal and Andreas Ronit and Ashley Roen and Amanda Mocroft and Jens Lundgren and B{\o}rge Nordestgaard and Henrik Sillesen and Anne-Mette Lebech and Lars K{\o}ber and Kofoed, {Klaus F} and Nielsen, {Susanne D.}",

year = "2018",

doi = "10.1097/QAI.0000000000001795",

language = "English",

volume = "79",

pages = "381--385",

journal = "J A I D S",

issn = "1525-4135",

publisher = "Lippincott Williams & Wilkins",

number = "3",

}

TY - JOUR

T1 - Prevalence of Peripheral Artery Disease Is Higher in Persons Living With HIV Compared With Uninfected Controls

T2 - Brief Report

AU - Knudsen, Andreas D.

AU - Gelpi, Marco

AU - Afzal, Shoaib

AU - Ronit, Andreas

AU - Roen, Ashley

AU - Mocroft, Amanda

AU - Lundgren, Jens

AU - Nordestgaard, Børge

AU - Sillesen, Henrik

AU - Lebech, Anne-Mette

AU - Køber, Lars

AU - Kofoed, Klaus F

AU - Nielsen, Susanne D.

PY - 2018

Y1 - 2018

N2 - OBJECTIVE: Ankle-brachial index is an excellent tool for diagnosing peripheral artery disease (PAD). We aimed to determine the prevalence and risk factors for PAD in people living with HIV (PLWH) compared with uninfected controls. We hypothesized that prevalence of PAD would be higher among PLWH than among controls independent of traditional cardiovascular disease (CVD) risk factors.METHODS: PLWH aged 40 years and older were recruited from the Copenhagen comorbidity in HIV infection (COCOMO) study. Sex- and age-matched uninfected controls were recruited from the Copenhagen General Population Study. We defined PAD as ankle-brachial index ≤0.9 and assessed risk factors for PAD using logistic regression adjusting for age, sex, smoking status, dyslipidemia, diabetes, hypertension, and high-sensitivity C-reactive protein.RESULTS: Among 908 PLWH and 11,106 controls, PAD was detected in 112 [12% confidence interval: (95% 10 to 14)] and 623 [6% (95% 5 to 6)], respectively (P < 0.001), odds ratio = 2.4 (95% 1.9 to 2.9), and adjusted odds ratio = 1.8 (95% 1.3 to 2.3, P < 0.001). Traditional CVD risk factors, but not HIV-related variables, were associated with PAD. The strength of the association between PAD and HIV tended to be higher with older age (P = 0.052, adjusted test for interaction).CONCLUSIONS: Prevalence of PAD is higher among PLWH compared with uninfected controls, especially among older persons, and remains so after adjusting for traditional CVD risk factors. Our findings expand the evidence base that PLWH have excess arterial disease to also include PAD. The exact biological mechanisms causing this excess risk remain to be elucidated. Until then, focus on management of modifiable traditional risk factors is important.

AB - OBJECTIVE: Ankle-brachial index is an excellent tool for diagnosing peripheral artery disease (PAD). We aimed to determine the prevalence and risk factors for PAD in people living with HIV (PLWH) compared with uninfected controls. We hypothesized that prevalence of PAD would be higher among PLWH than among controls independent of traditional cardiovascular disease (CVD) risk factors.METHODS: PLWH aged 40 years and older were recruited from the Copenhagen comorbidity in HIV infection (COCOMO) study. Sex- and age-matched uninfected controls were recruited from the Copenhagen General Population Study. We defined PAD as ankle-brachial index ≤0.9 and assessed risk factors for PAD using logistic regression adjusting for age, sex, smoking status, dyslipidemia, diabetes, hypertension, and high-sensitivity C-reactive protein.RESULTS: Among 908 PLWH and 11,106 controls, PAD was detected in 112 [12% confidence interval: (95% 10 to 14)] and 623 [6% (95% 5 to 6)], respectively (P < 0.001), odds ratio = 2.4 (95% 1.9 to 2.9), and adjusted odds ratio = 1.8 (95% 1.3 to 2.3, P < 0.001). Traditional CVD risk factors, but not HIV-related variables, were associated with PAD. The strength of the association between PAD and HIV tended to be higher with older age (P = 0.052, adjusted test for interaction).CONCLUSIONS: Prevalence of PAD is higher among PLWH compared with uninfected controls, especially among older persons, and remains so after adjusting for traditional CVD risk factors. Our findings expand the evidence base that PLWH have excess arterial disease to also include PAD. The exact biological mechanisms causing this excess risk remain to be elucidated. Until then, focus on management of modifiable traditional risk factors is important.

U2 - 10.1097/QAI.0000000000001795

DO - 10.1097/QAI.0000000000001795

M3 - Journal article

C2 - 29985264

SN - 1525-4135

VL - 79

SP - 381

EP - 385

JO - J A I D S

JF - J A I D S

IS - 3

ER -

Prevalence of Peripheral Artery Disease Is Higher in Persons Living With HIV Compared With Uninfected Controls: Brief Report

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