Peripheral arterial disease in HIV-infected and uninfected women

Objective: Although HIV infection has been associated with increased risk of subclinical atherosclerosis and cardiovascular events, peripheral arterial disease (PAD) has not been assessed in HIV-infected patients. The objective of this study was to determine the prevalence of, and risk factors for, PAD using ankle-brachial index (ABI) measurement in HIV-infected and uninfected women. Methods: ABI was determined for 335 participants in the Women's Interagency HIV Study (WIHS). A cross-sectional analysis was conducted to determine factors associated with high (≥1.40) ABI. Results: The prevalence of low ABI (≤0.9) was 0.9% (n = 3) and the prevalence of high ABI (≥1.40) was 6.9% (n = 23). The prevalence of low ABI was too low to allow risk factor analysis. On multivariate analysis, factors associated with high ABI were current cigarette smoking [adjusted odds ratio (OR adj) 2.53, 95% confidence interval (CI) 0.99-6.43], being underweight (OR adj 11.0, 95% CI 1.61-75.63) and being overweight (OR adj 5.40, 95% CI 1.13-25.89). Conclusions: Although the prevalence of ABI ≤0.9 was low in this cohort of HIV-infected and uninfected women, the prevalence of ABI ≥1.40 was unexpectedly high. Further studies are indicated to determine the clinical significance of high ABI and its relation to the risk of cardiovascular events in HIV-infected women.