HIV Infection and Carotid Artery Intima-media Thickness: Pooled Analyses Across 5 Cohorts of the NHLBI HIV-CVD Collaborative

Clin Infect Dis. 2016 Jul 15;63(2):249-56. doi: 10.1093/cid/ciw261. Epub 2016 Apr 26.


Background: Age and human immunodeficiency virus (HIV) treatment may affect the association of HIV infection with atherosclerosis.

Methods: We used identical carotid artery B-mode ultrasonographic methods in 5 cohorts participating in the National Heart, Lung, and Blood Institute HIV-CVD Collaborative to measure intima-media thickness of the right far wall of the common carotid artery (CCA-IMT) and carotid artery bifurcation (BIF-IMT) between 2010 and 2013. Participants aged 6-75 years were either HIV infected or uninfected. Linear regression assessed associations of CCA-IMT and BIF-IMT with HIV infection and cardiovascular disease risk factors, within age and HIV treatment groups. Adjustment variables included sex, race/ethnicity, smoking, height, weight, and use of antihypertensive and lipid-lowering drugs.

Results: We studied 867 HIV-infected and 338 HIV-uninfected male and 696 HIV-infected and 246 HIV-uninfected female participants. Among both middle-aged (30-49 years) and older adults (50-75 years), HIV-infected participants had CCA-IMT and BIF-IMT values that were similar to or lower than those in HIV-uninfected participants. In contrast, among those aged 6-29 years, HIV infection was associated with higher CCA-IMT and BIF-IMT values. Among HIV-infected participants, associations of higher systolic blood pressure and lower high-density lipoprotein cholesterol with Carotid artery intima-media thickness strengthened with age.

Conclusions: The effects of HIV on carotid artery structure may differ across the lifespan, with traditional determinants of cardiovascular disease burden playing a larger role and HIV playing a lesser role in older adults than in young adults and children.

Keywords: HIV infection; aging; biomarker; cardiovascular disease risk factors; carotid artery intima-media thickness.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Anti-HIV Agents / therapeutic use
  • Atherosclerosis / pathology
  • Atherosclerosis / virology*
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Common / pathology*
  • Carotid Intima-Media Thickness*
  • Child
  • Cohort Studies
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / pathology
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Ultrasonography
  • Young Adult


  • Anti-HIV Agents