Abstract
Calcium is a common component of an atherosclerotic plaque; therefore, the presence of coronary artery calcium (CAC) indicates atherosclerosis. This study investigated the difference in total CAC scores between HIV-infected patients treated with highly active antiretroviral therapy (HAART) and HIV-negative age-matched controls. HIV patients were 27 men treated with a protease inhibitor-containing HAART regimen for more than 1 year (M = 4.92 years, SD = 2.02), aged 30 to 60 years (M = 43.52 years, SD = 6.65), and not receiving lipid-lowering or hypoglycemic drugs. Controls were age-matched men randomly selected (three controls to one case, for a total of 81 controls) from our existing database of 25,250 men who self-referred for CAC screening (control database). Electron beam tomography was used to obtain CAC scores. The CAC scores were coded as above or below the age-specific (stratified in 5-year increments) 10th, 25th, 50th, 75th, or 90th percentile of our control database. Chi-square analyses for two independent samples indicated (1) a larger frequency of controls with CAC scores above the 10th ([chi]2(1) = 8.32, P = .004) and 25th ([chi]2(1) = 5.45, P = .02) percentiles than that of HIV patients, (2) no differences in CAC scores between groups above the 50th ([chi]2 = 0.85, P = .357) or 75th ([chi]2 = 0.46, P = .497) percentile, and (3) a larger frequency of HIV patients who were above the 90th percentile ([chi]2 = 4.5, P = .034). The strength of the relationship between group membership and scoring above the 90th percentile was significant ([script phi] = 0.20, P = .034). These results tentatively suggest that there is an elevated level of subclinical atherosclerosis in HIV patients treated with HAART.