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HIV/HCV Coinfected Women in WIHS Study Not at Greater Risk of Atherosclerosis

Among HIV positive women in the Women's Interagency HIV Study (WIHS), those coinfected with hepatitis C virus (HCV) were not more likely than those without HCV to have greater carotid intima-media thickness, an indicator of early atherosclerosis, according to a study published in the August 24, 2009 issue of AIDS.

By Liz Highleyman

Atherosclerosis refers to loss of elasticity and build-up of plaque within the arteries. The condition can affect arteries that supply the heart, leading to myocardial infarction, and bits of plaque can lodge in arteries in the brain, causing a stroke.

Several studies have shown that people with HIV have an increased risk of atherosclerosis. Other research indicates that people with chronic hepatitis C are also more likely to have coronary artery disease.

Phyllis Tien and colleagues examined the relationship between HIV and HCV infection and carotid artery intima-media thickness (thickness of the walls of the arteries in the neck that supply the brain) and presence of carotid plaques among 1675 HIV positive and at-risk women in the WIHS cohort (950 with HIV only, 53 with HCV only, 220 with HIV/HCV coinfection, and 452 with neither virus).

Results

Overall, HIV/HCV coinfected women were more likely to have traditional cardiovascular risk factors such as older age, smoking, high blood pressure, and diabetes.
Coinfected women were also less likely to be on antiretroviral therapy, had a higher HIV viral load, and had a lower CD4 cell count.
In an initial analysis, both HIV/HCV coinfected women and those with HCV alone had greater mean carotid intima-media thickness than women with HIV alone or neither virus.
After adjusting for traditional risk factors, however, coinfection was no longer associated with greater carotid intima-media thickness.
HIV/HCV coinfected women had somewhat more plaque build-up in their arteries, but the difference did not reach statistical significance.

The study authors concluded that further follow-up is needed to clarify whether coinfection may be associated with a greater risk of carotid plaque accumulation.

Department of Medicine, University of California, San Francisco, CA.

9/11/09

Reference
P Tien, MF Schneider, SR Cole, and others. Association of hepatitis C virus and HIV infection with subclinical atherosclerosis in the Women's Interagency HIV Study. AIDS 23(13):1781-1784. August 24, 2009. (Abstract).