Ankle-branch index and HIV: the role of antiretrovirals

HIV Med. 2009 Jan;10(1):1-5. doi: 10.1111/j.1468-1293.2008.00638.x. Epub 2008 Sep 14.

Abstract

Objective: To study the relationship between antiretroviral (ARV) treatment and abnormal ankle-branch index (ABI) and to compare the risk factors for altered ABI.

Methods: Patients coming to the office from April 2007 until July 2007 were offered the chance to take part in the study. ABI was obtained by the standard technique. Those < or = 0.9 or > or = 1.3 were considered altered ABI. Clinical reports were reviewed to examine traditional vascular risk factors, coinfection with hepatitis C virus and/or hepatitis B virus, tobacco use, highly active antiretroviral therapy use and its components and length of use of each ARV drug.

Results: ABI was measured in 147 patients, 82.3% males. Thirty-three patients (22.45%) had an altered ABI, and it was related to CD4 cell nadir, dyslipidaemia and protease inhibitor (PI) use. When logistic regression was carried out, only dyslipidaemia (OR 2.68, CI 95%: 1.06-6.91) and PI use (OR 2.79, CI 95%: 1.15-6.54) remained in the model.

Conclusions: Altered ABI is associated with PI use independently of dyslipidaemia. Probably, it marks patients with high vascular risk not identified with traditional scales.

MeSH terms

  • Adult
  • Ankle / blood supply*
  • Ankle Brachial Index / methods*
  • Antiretroviral Therapy, Highly Active
  • Blood Pressure / physiology
  • Brachial Artery / drug effects
  • Dyslipidemias / etiology*
  • Dyslipidemias / physiopathology
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / physiopathology
  • HIV Protease Inhibitors / adverse effects
  • HIV-1* / drug effects
  • Humans
  • Male
  • Peripheral Vascular Diseases / etiology*
  • Peripheral Vascular Diseases / physiopathology
  • Risk Assessment

Substances

  • HIV Protease Inhibitors