Neither HIV infection nor the use of protease inhibitors (PIs) appear to affect the rate of carotid artery intima media thickening (IMT) progression, AIDS investigators report. Neither HIV infection nor the use of protease inhibitors (PIs) appear to affect the rate of carotid artery intima media thickening (IMT) progression, AIDS investigators report, despite the lipid abnormalities that have been associated with PI therapy.

Dr. Judith S. Currier of the University of California at Los Angeles and colleagues at multiple sites across the US conducted a prospective, matched cohort study of 133 HIV clinic patients, divided into groups of three and matched by age, sex, race/ethnicity, smoking status, blood pressure and menopausal status.

Each group contained one HIV-positive patient who had been on continuous PI therapy for at least two years, one HIV-positive patient not on PI therapy and one HIV-uninfected subject.

Sequential carotid ultrasound imaging was conducted periodically over 144 weeks to measure rate of carotid IMT progression.

The median yearly carotid IMT progression rate was 0.0096 mm/year among HIV subjects on PIs, 0.0058 mm/year among HIV subjects not taking PIs and 0.0085 mm/year among uninfected individuals.

There were no significant differences between any of the three groups, Dr. Currier and colleagues report in the May 31st issue of AIDS.

"Larger prospective studies are needed to determine the precise contributions of specific antiviral agents to the progression of carotid IMT," the investigators report. They expect that this information will become more valuable as the HIV-infected population ages and modifiable risk factors will need to be identified.