New imaging study examines the coronary plaque burden of people living with HIV

People living with HIV (PLWH) have an especially high noncalcified coronary plaque burden, according to a new analysis published in Radiology.

While it was already known that cardiovascular disease is a leading cause of death among PLWH, the study’s authors said their findings highlight how important it is for this population to adopt a healthy lifestyle.

The authors evaluated imaging findings from 181 asymptomatic PLWH and another 84 participants who do not have HIV. No participants had known cardiovascular disease at the time of the analysis. All participants underwent coronary artery calcium scoring using non-contrast CT, and nearly 88% of them underwent coronary CT angiography.

Looking at coronary artery calcium scores and overall plaque prevalence, the authors found no significant difference between PLWH and the healthy controls. The 10-year Framingham Risk Score was also comparable between the two groups.

However, noncalcified plaque prevalence and volume were much higher—two to three times higher, in fact—among PLWH. This was even true when adjustments were made for other key cardiovascular risk factors such as age and smoking.

One potential reason for this discrepancy, the team noted, is antiretroviral therapy.

“Multiple studies suggest that there is probably an impact of antiretroviral therapy that could increase the risk of coronary artery disease, although there are far more advantages for PLWH to be on antiretroviral therapy, instead of not taking it,” lead author Carl Chartrand-Lefebvre, MD, MSc, a radiologist for Centre hospitalier de l'Université de Montréal in Montreal, said in a prepared statement.

To read the full study in Radiology, click here.