Frequency and factors associated with arterial remodeling in persons living with human immunodeficiency virus in Parakou in 2019

Background: The side effects of antiretroviral drugs and the chronic inflammation induced by human immunodeficiency virus (HIV) infection contribute to the development of atherosclerotic arterial remodeling in people living with HIV (PLWH).

Objectives: To determine the frequency and factors associated with arterial remodeling in PLWH treated at the university hospital of Parakou.

Methods: It was a cross-sectional, descriptive, and analytic study. Data were collected from March to August 2019 at the university hospital of Parakou in Benin. PLWH aged at least 18years and consenting were included. The diagnosis of arterial remodeling was retained in the presence of at least one of the following criteria: carotid intima-media thickness≥1mm, anteroposterior diameter of the abdominal aorta≥25mm, ankle brachial index<0.9, presence of atheromatous plaque. Data were recorded and analyzed with R 3.5.1 software, and the threshold of significance was 5%.

Results: A total of 114 patients have undergone arterial Doppler ultrasound. The majority were women (71.9%). The patients' mean age was 43.2±10.2years with extremes of 18 and 67years. The frequency of arterial remodeling was 24.6%. The most common atherosclerotic lesion found was atheromatous overload (IMT≥1mm). Age≥50y (p=0.003; ORa=4.9[1.5-15.6]), male sex (p=0.037; ORa=4.1[1.3-13.4]), and a family history of hypertension and/or diabetes (p=0.027; ORa=3.6[1.1-12.8]) were significantly associated with atherosclerosis in PLWH.

Conclusion: Arterial remodeling was frequent among PLWH in Parakou in 2019. The associated factors were the classic cardiovascular risk factors that should be systematically taken into account in the follow-up of these patients.