Chronic immune activation and inflammation are associated with an increased risk of
atherosclerosis in HIV-infected patients. In this review, we discuss the role of established
and novel imaging modalities to define more accurately the structure and function
of inflammation-mediated atherosclerosis in the context of HIV. Historically, carotid
ultrasound studies were the first to show higher rates of subclinical atherosclerosis
in HIV-infected subjects versus uninfected controls. However, computed tomography
is the noninvasive gold standard for imaging the coronary arteries, and studies in
HIV suggest a higher prevalence of noncalcified plaque. Endothelial dysfunction can
be quantified by measuring flow-mediated brachial artery dilation by ultrasound and
has been used extensively in antiretroviral switching trials and small pilot trials
of therapeutics to assess cardiovascular risk in this population. In the future, novel
imaging modalities such as intracoronary optical coherence tomography, positron emission
tomography imaging of 18F-fluorodeoxyglucose uptake, and molecular-targeted magnetic resonance imaging will
characterize the burden of vulnerable plaque and other unique features of inflammatory
atherosclerosis in HIV.
Abbreviations:
2-D (2-dimensional), 3-D (3-dimensional), ART (antiretroviral therapy), CIMT (carotid intima-media thickness), CT (computed tomography), CTA (computed tomography angiography), FDG (18F-fluorodeoxyglucose), FMD (flow mediated brachial artery dilation), IVUS (intravascular ultrasound), MACS (Multi-center AIDS Cohort Study), MRA (magnetic resonance imaging angiography), MRI (magnetic resonance imaging), OCT (optical coherence tomography), PET (positron emission tomography), PI (protease inhibitor), SPECT (single photon emission computed tomography), TCFA (thin-capped fibroatheroma), USPIO (ultrasmallsuperparamagnetic iron oxide), WIHS (Women's Interagency HIV Study)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 15, 2011
Accepted:
October 19,
2011
Received in revised form:
October 17,
2011
Received:
July 29,
2011
Footnotes
Supported by a research grant from Bristol-Myers Squibb (to C.T.L.).
Identification
Copyright
© 2012 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
