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Session 91 Poster Session Cardiovascular Disease Risk Session Time: 4:30-6:30 pm Room 4E-F

695-T. The Risk of Ischemic Cardiovascular Disease Is Significant in Persons with HIV Infection J. L. Wall*, M. David, and C. J. Fichtenbaum Univ. of Cincinnati Coll. of Med., OH Background: The risk of developing ischemic cardiovascular disease (CHD) is increasingly being evaluated in persons with HIV infection. There are few prospective data available on the risk of ischemic CHD in persons with HIV infection. Study objectives were to determine the risk of ischemic CHD in HIV-infected persons taking different antiretroviral regimens. Methods: We prospectively collected fasting blood samples from HIV-infected persons taking different antiretroviral regimens; treatment-naïve HIV-infected persons and HIV negative controls for cross-sectional analysis. Samples were tested for cholesterol, LDL, triglycerides (TG), HDL, Lp (a), homocysteine, and fibrinogen. LDL was calculated unless the TG was > 400 and then was directly measured. Information was collected about ischemic CHD risk factors including: cigarette smoking, hypertension, a family history of premature CHD, exercise, diabetes mellitus, and other cardiovascular disease risk equivalents. Body mass index and blood pressure were collected. The ATP3 Framingham score was used to measure cardiovascular risk. Results: 111 HIV-infected persons and 25 controls were evaluated. The median age of the HIV+ cohort was 41 years; 89% were male. The median CD4 count was 423 cells/mm3 and 51% of antiretroviral treated subjects had undetectable viral loads. The median age of the HIV negative cohort was 39 years; 40% were male. The median risk for progression of CHD in 10 years was 4% (range, <1% to >30%) in the HIV-infected cohort and was 1% (range, <1 to 20%) in the HIV negative cohort (p < 0.05). In the HIV-infected cohort, the median risk for progression of CHD in 10 years was 6% (range, <1%-30%) in PI-treated subjects vs 3% (range, <1%-25%) in those not treated with PIs (p< 0.05). 22% of the HIV-infected cohort had a >10% risk of progression of CHD in the next 10 years indicating the need for risk reduction interventions. Conclusions: There is a significant prevalence of risk for the progression of ischemic cardiovascular disease in persons with HIV infection. The risk is higher among those treated with protease inhibitors. Cardiovascular risk should be assessed in all persons with HIV infection and risk reduction efforts should be aggressively pursued. Longitudinal studies are needed to assess the change in cardiovascular risk over time.

©2002 9th Conference on Retroviruses and Opportunistic Infections