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Issue No. 25 | June 15, 2012

News and Features

Study Evaluates Association Between CD4 Counts and Cardiovascular Risk in HIV-Infected People Receiving Antiretroviral Therapy

“HIV-infected individuals are at high risk of developing cardiovascular disease. Whether earlier initiation of HIV therapy at higher CD4 cell counts has any effect on cardiovascular risk as assessed by endothelial function is unknown. …

“Participants underwent noninvasive assessment of endothelial function using brachial artery flow-mediated dilation (FMD). …

“The median age was 47 years [interquartile range (IQR) 42-55], median current CD4 T-cell count was 659cells/μl (IQR 542-845), and nadir CD4 cell count was 314cells/μl (IQR 150-490). Twenty-eight percent had hypertension, and 32% hyperlipidemia. Nadir CD4 T-cell count less than 350cells/μl was associated with lower FMD in age-adjusted and race-adjusted analyses and remained an independent predictor of FMD after adjustment for cardiovascular risk factors (hypertension, diabetes, smoking, hyperlipidemia) and HIV-related characteristics (HIV duration, HAART duration). After multivariable adjustment, individuals with nadir CD4 T-cell count less than 350cells/μl had a 1.22% lower FMD compared with those with higher T-cell counts [95% confidence interval (CI) -2.20 to -0.19, P=0.02]. …

“Among treated HIV-infected individuals, nadir CD4 T-cell count less than 350cells/μl is independently associated with lower FMD, suggesting that delayed therapy results in sustained harm to endothelial function. Our data support future prospective studies evaluating cardiovascular effects of HAART initiation at higher CD4 cell counts.”

More information is available:

CDC Updates “HIV Surveillance in Adolescents and Young Adults” Slide Set

The Centers for Disease Control and Prevention (CDC) recently updated the “HIV Surveillance in Adolescents and Young Adults” slide set. This slide set provides statistical information on diagnoses of HIV infection and AIDS in adolescents and young adults in the United States and dependent areas, broken down by race/ethnicity, transmission category, sex, and age group.