ABC | Volume 114, Nº1, January 2019

Original Article Leite et al. Carotid thickness in HIV-infected patients Arq Bras Cardiol. 2020; 114(1):90-97 Table 3 – Risk factors related to carotid intima-media thickness, stratified according to the condition of HIV infection Variables HIV+ HIV- < 0.61 mm ≥ 0.61 mm p-value < 0.61 mm ≥ 0.61 mm p-value Age a (years) 37.9 ± 7.1 46.3 ± 8.5 < 0.001 44.0 ± 9.8 52.4 ± 7.0 0.063 Age group < 40 29 (60.4%) 11 (21.6%) < 0.001 b 3 (42.9%) 1 (11.1%) 0.192 † ≥ 40 19 (39.6%) 40 (78.4%) 4 (57.1%) 8 (88.9%) Gender Female 19 (39.6%) 20 (39.2%) 0.970 2 (28.6%) 2 (22.2%) 0.608 Male 29 (60.4%) 31 (60.8%) 5 (71.4%) 7 (77.8%) Smoking Yes 3 (6.3%) 9 (17.7%) 0.082 0 (-) 0 (-) - No 45 (93.7%) 42 (82.3%) 7 (100%) 9 (100%) Diabetes Yes 1 (2.1%) 2 (3.9%) 0.594 0 (-) 0 (-) - No 47 (97.9%) 49 (96.1%) 7 (100%) 9 (100%) Lipidogram (mg/dL) Total cholesterol * 178.1 ± 33.8 199.9 ± 58.3 0.395 175.7 ± 31.5 191.8 ± 37.4 0.023 HDL * 41.5 ± 9.8 45.2 ± 5.9 0.362 50.4 ± 17.6 50.1 ± 10.3 0.931 LDL * 110.9 ± 23.3 124.4 ± 47.4 0.504 98.5 ± 21.7 111.4 ± 30.2 0.020 Triglycerides ‡ 113 (72; 181) 118 (86; 174) 0.459 117 (86; 169) 122 (101; 200) 0.560 Inflammatory markers ‡ PCR US 0.1 (0; 0.4) 0.1 (0; 0.4) 0.966 0.1 (0; 0.6) 0.1 (0; 0.1) 0.581 ICAM-1 ¥ - - - - - - VCAM-1(x10 -3 ) 12.1 (11.3; 12.6) 12.0 (11.4; 12.6) 0.931 13.0 (6.6; 13.6) 12.9 (10.8; 13.4) 1.000 IFN 2.16 (1.98; 2.37) 2.21 (1.93; 2.43) 0.481 2.91 (1.96; 3.24) 2.66 (2.32; 2.72) 0.368 IL-1 2.87 (2.87; 2.87) 2.87 (2.87; 2.87) 1.000 2.87 (2.87; 4.40) 2.87 (2.87; 3.77) 0.597 IL-6 ¥ - - - - - 0.149 TNF-α 2.26 (2.26; 2.26) 2.26 (2.26; 2.26) 0.328 2.26 (2.26; 6.75) 2.26 (2.26; 13.7) 0.634 Time of ART (years) ≤ 5 19 (43.2%) 15 (31.2%) 0.383 - - - 5–10 13 (29.5%) 14 (29.2%) - - - ≥ 10 12 (27.3%) 19 (39.6%) - - - *Media ± standard deviation - Independent Student's t-test was applied. † OR Crude, 5.47 (2.41–12.93); OR Mantel–Haenszel, 5.60 (2.43–12.9). ‡ Median (P25; P75) – Mann–Whitney test. ¥ There is no variation (all values equal to the minimum). HDL: high-density lipoprotein; LDL: low-density lipoprotein; ART: antiretroviral therapy. Conclusions HIV-positive individuals with undetectable HIV-1 RNA viral load, at low risk for cardiovascular disease, using NRTI and NNRTI presented similar carotid thickness compared with non-infected people. Inflammatory markers IL-6, hs‑CRP, sVCAM-1, and sICAM-1 showed similar levels in the studied groups and IFN- γ , IL-1, and TNF- α had lower levels in the HIV population. Evaluating the association between inflammatory markers and CIMT, in the multivariate analysis, TNF- α and IL1- β were shown to be associated with a greater chance of higher carotid thickness. Our study demonstrates that HIV-positive individuals with undetectable viral load in ART without protease inhibitors and with low cardiovascular risk do not present differences in carotid thickness in relation to uninfected individuals. Control of viral load with NRTIs and NNRTI plus the maintenance of cardiovascular risk parameters under control – such as smoking, diabetes, and dyslipidaemia – possibly result in the patient with HIV having lower risk of occurrence of subclinical atherosclerosis. Author contributions Conception and design of the research, Statistical analysis and Writing of the manuscript: Leite KME; Acquisition of data: Leite KME, Santos Júnior GG, Godoi ETAM, Vasconcelos AF, 95