icon-    folder.gif   Conference Reports for NATAP  
  19th Conference on Retroviruses and
Opportunistic Infections
Seattle, WA March 5 - 8, 2012
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Subclinical Carotid Atherosclerosis Is Related to HIV Infection and Low Adherence to a Mediterranean Diet
  Reported by Jules Levin
CROI 2012 March 5-8 Seattle WA
K Viskovic1, G Rutherford2, G Sudario2, L Stemberger1, and Josip Begovac*1 1Univ Hosp for Infectious Diseases, Zagreb, Croatia and 2Univ of California, San Francisco Sch of Med, US


Background: The Mediterranean diet is characterized by high consumption of legumes, fruits, vegetables, grains and olive oil, moderate intake of fish, wine and dairy products and a low consumption of red and processed meat, cream and pastries. We conducted a cross-sectional study on the association between consuming a Mediterranean diet on carotid intima media thickness (CIMT) and plaque area in HIV+ subjects and HIV- controls between July 2009 and April 2011.
Methods: We enrolled 131 participants ≥18 years without a history of cardiovascular disease (CVD) who had been treated with ART for ≥1 year and 131 uninfected controls. We measured CIMT and plaque area using ultrasound broadband high-frequency linear transducer. We considered subclinical atherosclerosis to be present if a participant had CIMT ≥0.9 mm or a visible plaque in carotid arteries. A 14-point food-items questionnaire was used to assess adherence to the Mediterranean diet and the score was dichotomized at the median. We also examined traditional risk factors for subclinical atherosclerosis: age, smoking, gender, family history of CVD, hypertension, and HIV status. Statistical analysis included the c2 test and multivariable logistic regression analysis with subclinical atherosclerosis as the dependent variable.
Results: Subclinical atherosclerosis was found in 87 (33.2%) of 262 participants. We found low adherence to the Mediterranean diet (score <4) more frequently in uninfected controls (50%) than in HIV+ individuals (34%) (p = 0.006). In participants ≥45 years we found subclinical atherosclerosis more frequently in HIV+ individuals than controls (40 of 71 vs 40 of 100, p = 0.035). In the multivariable model low adherence to the Mediterranean diet was significantly associated with subclinical atherosclerosis (OR 2.5, 95%CI 1.2 to 5.0, p = 0.010) along with smoking (OR 3.5), hypertension (systolic blood pressure >140 mmHg) (OR 2.8), and male gender (OR 2.4). At the age of 55 years the multivariable model suggested that HIV+ individuals had 2.3 higher odds (95%CI 1.1 to 4.8) for subclinical atherosclerosis compared to uninfected controls (p = 0.031).
Conclusions: Low adherence to the Mediterranean diet was an independent predictor of subclinical atherosclerosis, and HIV infection was independently associated with subclinical atherosclerosis in older individuals.