Low prevalence of peripheral arterial disease in a cross-sectional study of Danish HIV-infected patients.

Background: Patients infected with human immunodeficiency virus (HIV) appear to be at increased risk of cardiovascular disease (CVD). The ankle-brachial index (ABI) is a well-established screening tool for peripheral arterial disease (PAD) and future cardiovascular events in the general population. However, controversies exist on the prevalence of PAD among HIV-infected patients. In this study we aimed to measure the prevalence of PAD among HIV-infected patients and compare the ABI with carotid intima-media thickness (cIMT) and other known CVD risk predictors.

Methods: We prospectively included HIV-infected patients from an outpatient clinic at the Department of Infectious Diseases, Hvidovre University Hospital, Denmark. We assessed the ABI pre- and post-exercise with a threshold for PAD defined as ABI ≤ 0.9. All patients had cIMT measured at the far wall of the distal common carotid artery.

Results: Of 102 patients included (mean age 52 years, 75% male, 94% receiving antiretroviral therapy (ART), 33% active smokers), 1 had a pre-exercise ABI ≤ 0.9 and in addition 3 patients had a post-exercise ABI ≤ 0.9. We found a poor correlation between ABI and traditional CVD risk factors other than body mass index. In contrast, a strong correlation was found between cIMT and traditional risk factors. Values of post-exercise ABI and cIMT were not correlated. The current ART did not influence ABI values.

Conclusions: We found a low prevalence of PAD in HIV-infected patients. ABI did not correlate with CVD risk factors or cIMT. Based on these results ABI does not seem valuable as a screening tool for CVD among HIV-infected patients.