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Subclinical Atherosclerosis Imaging in People Living with HIV

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Schoepf Isabella C., Buechel Ronny R., Kovari Helen, Hammoud Dima A., Tarr Philip E.,
Project Dynamics of atherosclerosis progression in HIV-infected and HIV-uninfected persons - a longitudinal study using coronary computed tomography angiography
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Original article (peer-reviewed)

Journal Journal of Clinical Medicine
Volume (Issue) 8(8)
Page(s) 1125 - 1125
Title of proceedings Journal of Clinical Medicine
DOI 10.3390/jcm8081125

Open Access

URL http://doi.org/10.3390/jcm8081125
Type of Open Access Publisher (Gold Open Access)

Abstract

In many, but not all studies, people living with HIV (PLWH) have an increased risk of coronary artery disease (CAD) events compared to the general population. This has generated considerable interest in the early, non-invasive detection of asymptomatic (subclinical) atherosclerosis in PLWH. Ultrasound studies assessing carotid artery intima-media thickness (CIMT) have tended to show a somewhat greater thickness in HIV+ compared to HIV−, likely due to an increased prevalence of cardiovascular (CV) risk factors in PLWH. Coronary artery calcification (CAC) determination by non-contrast computed tomography (CT) seems promising to predict CV events but is limited to the detection of calcified plaque. Coronary CT angiography (CCTA) detects calcified and non-calcified plaque and predicts CAD better than either CAC or CIMT. A normal CCTA predicts survival free of CV events over a very long time-span. Research imaging techniques, including black-blood magnetic resonance imaging of the vessel wall and 18F-fluorodeoxyglucose positron emission tomography for the assessment of arterial inflammation have provided insights into the prevalence of HIV-vasculopathy and associated risk factors, but their clinical applicability remains limited. Therefore, CCTA currently appears as the most promising cardiac imaging modality in PLWH for the evaluation of suspected CAD, particularly in patients <50 years, in whom most atherosclerotic coronary lesions are non-calcified.
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