Peripheral Artery Disease Common in HIV Patients

　　There is a considerably elevated prevalence of peripheral arterial disease (PAD) in HIV-infected patients, Swiss researchers report in the March 1st issue of Clinical Infectious Diseases.
　　Dr. Daniel Periard of University Hospital, Lausanne and colleagues note that although atherosclerosis has been assessed in HIV-positive patients, PAD has not been evaluated.
　　To do so, the researchers studied 92 subjects. Claudication was reported by 15.2%, PAD was found in 20.7% of the patients and 9.8% had an abnormal systolic ankle-brachial blood pressure index (ABI) at rest. A further 10.9% had normal ABI at rest but a greater than 25% decrease after exercise.
　　Most of the patients with PAD were further investigated with duplex scan, and all of this group had atherosclerotic occlusions or stenoses of the iliac or femoral arteries. Among independent predictors of PAD were age, smoking, and low CD4+ T lymphocyte counts.
　　Large epidemiological studies, the investigators point out, have reported a prevalence of PAD in the general population of about 1% at 50 years of age and around 3% at 60 years of age. The 20.7% prevalence in the current group with a median age of 49.5 years "is therefore strikingly higher than expected."
　　The researchers call for further studies but note that "patients can be easily and reliably identified by ABI testing, and they presumably are at increased cardiovascular risk." Identification of patients with PAD, the team concludes, "could serve to promote aggressive efforts at cardiovascular risk reduction."
　　Clin Infect Dis 2008;46:761-767.