"Therapies for HIV disease may be associated with increased cardiovascular risk, and this should be monitored while patients are on such drugs," Dr. Steve Grinspoon from Massachusetts General Hospital and Harvard Medical School, Boston, told Reuters Health.

Dr. Grinspoon and associates investigated carotid IMT among 97 HIV-infected women and 86 matched, HIV-negative controls and assessed individual risk factors for increased IMT.

Overall, HIV-infected women did not have increased carotid IMT compared with control women, the authors report. Women treated with protease inhibitors, however, had significantly higher carotid IMT than did women not treated with protease inhibitors.

Among healthy controls, age and waist-to-hip ratio were significantly related to carotid IMT, the report indicates. Among HIV-infected women, age and waist circumference were significantly related to carotid IMT. Current protease inhibitor use also approached statistical significance.

Metabolic syndrome was more common among HIV-infected patients (31%) than among healthy controls (4%), the researchers note, and it was more common among women treated with protease inhibitors (45%) than among women not treated with protease inhibitors (19%).

"Antiretroviral drugs save lives, so they are critical for HIV infected men and women alike, but our data do suggest that use of these drugs, particularly protease inhibitors, among women, may be associated with accelerated atherosclerosis," Dr. Grinspoon said. "Thus, patients put on these medications should have a careful monitoring for the development of coronary artery disease risk factors and potentially assessment with IMT."

"We plan to study other cardiovascular endpoints, including coronary artery calcium score, to confirm adverse effects of antiretroviral therapies on cardiovascular endpoints," Dr. Grinspoon added.

J Clin Endocrinol Metab 2006;91:4916-4924.

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