Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men

David B. Hanna, Jee Young Moon, Sabina A. Haberlen, Audrey L. French, Frank J. Palella, Stephen J. Gange, Mallory D. Witt, Seble Kassaye, Jason M. Lazar, Phyllis C. Tien, Matthew J. Feinstein, Lawrence A. Kingsley, Wendy S. Post, Robert C. Kaplan, Howard N. Hodis, Kathryn Anastos

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE: Among people with HIV, there are few long-term studies of noninvasive ultrasound-based measurements of the carotid artery predicting major health events. We hypothesized that such measurements are associated with 10-year mortality in the Women's Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS), and that associations differ by HIV serostatus.

DESIGN: Nested cohort study.

METHODS: Participants without coronary heart disease underwent B-mode carotid artery ultrasound, with measurement of common carotid artery intima-media thickness (IMT); carotid artery plaque (focal IMT > 1.5 mm) at six locations; and Young's modulus of elasticity, a measure of arterial stiffness. We examined all-cause mortality using Cox models, controlling for demographic, behavioral, cardiometabolic, and HIV-related factors.

RESULTS: Among 1722 women (median age 40 years, 90% nonwhite, 71% HIV-positive) and 1304 men (median age 50, 39% nonwhite, 62% HIV-positive), 11% died during follow-up. Mortality was higher among HIV-positive women [19.9 deaths/1000 person-years, 95% confidence interval (CI) 14.7-28.8] than HIV-positive men (15.1/1000, 95% CI 8.3-26.8). In adjusted analyses, plaque was associated with mortality (hazard ratio 1.44, 95% CI 1.10-1.88) regardless of HIV serostatus, and varied by sex (among women, hazard ratio 1.06, 95% CI 0.74-1.52; among men; hazard ratio 2.19, 95% CI 1.41-3.43). The association of plaque with mortality was more pronounced among HIV-negative (hazard ratio 3.87, 95% 1.95-7.66) than HIV-positive participants (hazard ratio 1.35, 95% CI 1.00-1.84). Arterial stiffness was also associated with mortality (hazard ratio 1.43 for highest versus lowest quartile, 95% CI 1.02-2.01). Greater common carotid artery-IMT was not associated with mortality.

CONCLUSION: Carotid artery plaque was predictive of mortality, with differences observed by sex and HIV serostatus.

Original languageEnglish (US)
Pages (from-to)2393-2403
Number of pages11
JournalAIDS (London, England)
Volume32
Issue number16
DOIs
StatePublished - Oct 23 2018

Fingerprint

Carotid Artery Diseases
Carotid Arteries
HIV
Mortality
Confidence Intervals
Carotid Intima-Media Thickness
Vascular Stiffness
Elastic Modulus
Carotid Stenosis
Common Carotid Artery
Cohort Studies
Proportional Hazards Models
Sex Characteristics
Multicenter Studies
Coronary Disease
Acquired Immunodeficiency Syndrome
Demography

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men. / Hanna, David B.; Moon, Jee Young; Haberlen, Sabina A.; French, Audrey L.; Palella, Frank J.; Gange, Stephen J.; Witt, Mallory D.; Kassaye, Seble; Lazar, Jason M.; Tien, Phyllis C.; Feinstein, Matthew J.; Kingsley, Lawrence A.; Post, Wendy S.; Kaplan, Robert C.; Hodis, Howard N.; Anastos, Kathryn.

In: AIDS (London, England), Vol. 32, No. 16, 23.10.2018, p. 2393-2403.

Research output: Contribution to journalArticle

Hanna, DB, Moon, JY, Haberlen, SA, French, AL, Palella, FJ, Gange, SJ, Witt, MD, Kassaye, S, Lazar, JM, Tien, PC, Feinstein, MJ, Kingsley, LA, Post, WS, Kaplan, RC, Hodis, HN & Anastos, K 2018, 'Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men', AIDS (London, England), vol. 32, no. 16, pp. 2393-2403. https://doi.org/10.1097/QAD.0000000000001972
Hanna, David B. ; Moon, Jee Young ; Haberlen, Sabina A. ; French, Audrey L. ; Palella, Frank J. ; Gange, Stephen J. ; Witt, Mallory D. ; Kassaye, Seble ; Lazar, Jason M. ; Tien, Phyllis C. ; Feinstein, Matthew J. ; Kingsley, Lawrence A. ; Post, Wendy S. ; Kaplan, Robert C. ; Hodis, Howard N. ; Anastos, Kathryn. / Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men. In: AIDS (London, England). 2018 ; Vol. 32, No. 16. pp. 2393-2403.
@article{7dd0893ba4664e5e99d8bf6a49fb3081,
title = "Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men",
abstract = "OBJECTIVE: Among people with HIV, there are few long-term studies of noninvasive ultrasound-based measurements of the carotid artery predicting major health events. We hypothesized that such measurements are associated with 10-year mortality in the Women's Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS), and that associations differ by HIV serostatus.DESIGN: Nested cohort study.METHODS: Participants without coronary heart disease underwent B-mode carotid artery ultrasound, with measurement of common carotid artery intima-media thickness (IMT); carotid artery plaque (focal IMT > 1.5 mm) at six locations; and Young's modulus of elasticity, a measure of arterial stiffness. We examined all-cause mortality using Cox models, controlling for demographic, behavioral, cardiometabolic, and HIV-related factors.RESULTS: Among 1722 women (median age 40 years, 90{\%} nonwhite, 71{\%} HIV-positive) and 1304 men (median age 50, 39{\%} nonwhite, 62{\%} HIV-positive), 11{\%} died during follow-up. Mortality was higher among HIV-positive women [19.9 deaths/1000 person-years, 95{\%} confidence interval (CI) 14.7-28.8] than HIV-positive men (15.1/1000, 95{\%} CI 8.3-26.8). In adjusted analyses, plaque was associated with mortality (hazard ratio 1.44, 95{\%} CI 1.10-1.88) regardless of HIV serostatus, and varied by sex (among women, hazard ratio 1.06, 95{\%} CI 0.74-1.52; among men; hazard ratio 2.19, 95{\%} CI 1.41-3.43). The association of plaque with mortality was more pronounced among HIV-negative (hazard ratio 3.87, 95{\%} 1.95-7.66) than HIV-positive participants (hazard ratio 1.35, 95{\%} CI 1.00-1.84). Arterial stiffness was also associated with mortality (hazard ratio 1.43 for highest versus lowest quartile, 95{\%} CI 1.02-2.01). Greater common carotid artery-IMT was not associated with mortality.CONCLUSION: Carotid artery plaque was predictive of mortality, with differences observed by sex and HIV serostatus.",
author = "Hanna, {David B.} and Moon, {Jee Young} and Haberlen, {Sabina A.} and French, {Audrey L.} and Palella, {Frank J.} and Gange, {Stephen J.} and Witt, {Mallory D.} and Seble Kassaye and Lazar, {Jason M.} and Tien, {Phyllis C.} and Feinstein, {Matthew J.} and Kingsley, {Lawrence A.} and Post, {Wendy S.} and Kaplan, {Robert C.} and Hodis, {Howard N.} and Kathryn Anastos",
year = "2018",
month = "10",
day = "23",
doi = "10.1097/QAD.0000000000001972",
language = "English (US)",
volume = "32",
pages = "2393--2403",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "16",

}

TY - JOUR

T1 - Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men

AU - Hanna, David B.

AU - Moon, Jee Young

AU - Haberlen, Sabina A.

AU - French, Audrey L.

AU - Palella, Frank J.

AU - Gange, Stephen J.

AU - Witt, Mallory D.

AU - Kassaye, Seble

AU - Lazar, Jason M.

AU - Tien, Phyllis C.

AU - Feinstein, Matthew J.

AU - Kingsley, Lawrence A.

AU - Post, Wendy S.

AU - Kaplan, Robert C.

AU - Hodis, Howard N.

AU - Anastos, Kathryn

PY - 2018/10/23

Y1 - 2018/10/23

N2 - OBJECTIVE: Among people with HIV, there are few long-term studies of noninvasive ultrasound-based measurements of the carotid artery predicting major health events. We hypothesized that such measurements are associated with 10-year mortality in the Women's Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS), and that associations differ by HIV serostatus.DESIGN: Nested cohort study.METHODS: Participants without coronary heart disease underwent B-mode carotid artery ultrasound, with measurement of common carotid artery intima-media thickness (IMT); carotid artery plaque (focal IMT > 1.5 mm) at six locations; and Young's modulus of elasticity, a measure of arterial stiffness. We examined all-cause mortality using Cox models, controlling for demographic, behavioral, cardiometabolic, and HIV-related factors.RESULTS: Among 1722 women (median age 40 years, 90% nonwhite, 71% HIV-positive) and 1304 men (median age 50, 39% nonwhite, 62% HIV-positive), 11% died during follow-up. Mortality was higher among HIV-positive women [19.9 deaths/1000 person-years, 95% confidence interval (CI) 14.7-28.8] than HIV-positive men (15.1/1000, 95% CI 8.3-26.8). In adjusted analyses, plaque was associated with mortality (hazard ratio 1.44, 95% CI 1.10-1.88) regardless of HIV serostatus, and varied by sex (among women, hazard ratio 1.06, 95% CI 0.74-1.52; among men; hazard ratio 2.19, 95% CI 1.41-3.43). The association of plaque with mortality was more pronounced among HIV-negative (hazard ratio 3.87, 95% 1.95-7.66) than HIV-positive participants (hazard ratio 1.35, 95% CI 1.00-1.84). Arterial stiffness was also associated with mortality (hazard ratio 1.43 for highest versus lowest quartile, 95% CI 1.02-2.01). Greater common carotid artery-IMT was not associated with mortality.CONCLUSION: Carotid artery plaque was predictive of mortality, with differences observed by sex and HIV serostatus.

AB - OBJECTIVE: Among people with HIV, there are few long-term studies of noninvasive ultrasound-based measurements of the carotid artery predicting major health events. We hypothesized that such measurements are associated with 10-year mortality in the Women's Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS), and that associations differ by HIV serostatus.DESIGN: Nested cohort study.METHODS: Participants without coronary heart disease underwent B-mode carotid artery ultrasound, with measurement of common carotid artery intima-media thickness (IMT); carotid artery plaque (focal IMT > 1.5 mm) at six locations; and Young's modulus of elasticity, a measure of arterial stiffness. We examined all-cause mortality using Cox models, controlling for demographic, behavioral, cardiometabolic, and HIV-related factors.RESULTS: Among 1722 women (median age 40 years, 90% nonwhite, 71% HIV-positive) and 1304 men (median age 50, 39% nonwhite, 62% HIV-positive), 11% died during follow-up. Mortality was higher among HIV-positive women [19.9 deaths/1000 person-years, 95% confidence interval (CI) 14.7-28.8] than HIV-positive men (15.1/1000, 95% CI 8.3-26.8). In adjusted analyses, plaque was associated with mortality (hazard ratio 1.44, 95% CI 1.10-1.88) regardless of HIV serostatus, and varied by sex (among women, hazard ratio 1.06, 95% CI 0.74-1.52; among men; hazard ratio 2.19, 95% CI 1.41-3.43). The association of plaque with mortality was more pronounced among HIV-negative (hazard ratio 3.87, 95% 1.95-7.66) than HIV-positive participants (hazard ratio 1.35, 95% CI 1.00-1.84). Arterial stiffness was also associated with mortality (hazard ratio 1.43 for highest versus lowest quartile, 95% CI 1.02-2.01). Greater common carotid artery-IMT was not associated with mortality.CONCLUSION: Carotid artery plaque was predictive of mortality, with differences observed by sex and HIV serostatus.

UR - http://www.scopus.com/inward/record.url?scp=85054466782&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054466782&partnerID=8YFLogxK

U2 - 10.1097/QAD.0000000000001972

DO - 10.1097/QAD.0000000000001972

M3 - Article

C2 - 30102657

AN - SCOPUS:85054466782

VL - 32

SP - 2393

EP - 2403

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 16

ER -