Ultrasound diagnosis of preclinical atherosclerosis in patients with HIV infection
Klaudija Višković Josip Begovac
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Sažetak In patients infected with human immunodeficiency virus (HIV), cardiovascular diseases (CVD) are the leading cause of death in Europe and North America. The traditional risk factors are smoking, high blood pressure, age, sex, and race, but there are also other specific factors such as chronic inflammation due to HIV infection, metabolic changes associated with highly active antiretroviral therapy, particularly protease inhibitors (PI), and lipodystrophy. Ultrasound measurements of carotid intima-media thickness (IMT) and evidence of carotid plaque are important surrogate markers for the assessment of preclinical atherosclerosis. Carotid arterial stiffness is also a marker of increased CV risk and independent predictor of CV events and mortality in HIV-infected patients. Identification of markers of increased CVD risk may contribute to preventive measures by early identification of high-risk patients who may be potential candidates for an interventional procedure. Assessment and modification of cardiovascular risk factors plays an important role in the management of patients with HIV infection.