Revista de SIDA e investigación clínica

Comparison of Cerebrovascular Risk between Elderly Human Immunodeficiency Virus-seropositive Patients Treated with Highly Active Antiretroviral Therapy and Human Immunodeficiency Virus-seronegative Patients

Abstract

Guilherme Rocha Pardi, Maria Luisa Pereira Gomes, Fernando Henrique Guimarães de Carvalho, Luis Gonzaga Silveira Filho, Luis Ronan M. Ferreira de Souza and Dalmo Correia

Introduction: The current era of AIDS is characterized by an aging of population and increase in the incidence of non-acquired immune deficiency syndrome-related diseases. The aim of the present study was to compare the cerebrovascular risk in elderly HIV(+) patients under HAART therapy with seronegative elderly.

Materials and method: This transversal study was performed between January 2011 and December 2013, and evaluated 2 groups of individuals older than 60 years. The first group included elderly HIV(+) patients who had been receiving HAART for over 1 year, and the second group included elderly HIV(−) patients. To detect cerebrovascular risk in groups, anthropometric assessments (body mass index and waist circumference), clinical evaluations (Framingham score), and laboratory assessments (carotid Doppler ultrasonography and brain magnetic resonance imaging [MRI]) were performed.

Results: The HIV(+) group included 26 patients and the HIV(−) group included 40 patients. The cerebrovascular risks based on body mass index (P=0.001), the Framingham score (P=0.02), and the presence of lesions on MRI (P=0.03) were lower in the HIV(+) group than in the HIV(−) group. Moderate to severe cerebrovascular risk according to the Framingham score was 3 times more likely among infected patients than among non-infected patients (P=0.03). Additionally, patients who had received more than 10 years of HAART had a 90% lower chance of cerebrovascular disease if they presented with a Framingham score indicating moderate to high risk than if they presented with a Framingham score indicating mild risk (P=0.03).

Conclusion: Our results suggest that the presence of HIV infection in elderly patients might increase the risk of cerebrovascular events. The risk might be low in patients who receive HAART for more than 10 years, indicating that HAART might have the potential to reduce the risk of cerebrovascular events.