Ultrasound Characteristics And Influencing Factors Of Carotid And Vertebral Arteries In AIDS Patients

[Objective]To analyze the characteristics of carotid and vertebral arteries in AIDS patients and its related factors.[Method]A total of 169 patients were enrolled between April 2003 and December 2019 in Peking union medical college hospital outpatient follow-up regularly,including 161 males and 8 females,average age 38.05±0.81 years old.They underwent ultrasound examinations of the cervical and vertebral arteries from July 2015 to December 2019.Their height,weight,bilateral carotid and vertebral artery ultrasound reports,smoking,drinking,complications(hypertension,etc.),time of the antiviral treat-ment,blood biochemistry,viral load,TB lymphocyte substes,etc.,were recorded.Logistic regression analysis was used to investigate the risk factors associated with carotid artery abnormalities,and t-test was used for ultrasonic comparative analysis of HIV-positive and HIV-negative people.[Results]The results of Logistic regression model showed that the risk of carotid artery abnormality was increased in non-young people(middle-aged and elderly people)compared with young people(OR:3.85,95%CI:1.54-9.65).People with hypertension had an increased risk of developing abnormal carotid arteries compared to those without hypertension(OR:6.24,95%CI:1.95-20.00).Compared with non-hyperlipidemia patients,hyperlipi-demia patients had an increased risk of carotid artery abnormalities(OR:2.44,95%CI:1.00-5.93).With the increase of HLA-DR+CD8+/CD8+,the risk of carotid artery abnormality increased(OR:1.03,95%CI:1.01-1.06).Logistic regression model results of increased vertebral artery resistance index showed that smokers had an increased risk of increased vertebral artery resistance index(OR:3.51,95%CI:1.33-9.24)compared with non-smokers.With the increase of HLA-DR+CD8+/CD8+,the risk of vertebral artery resistance index increased(OR:1.02,95%CI:1.00-1.05).With the increase of CD8+CD38+/CD8+,the risk of occurrence of increased vertebral artery resistance index increased(OR:1.03,95%CI:1.00-1.05).Compared with HIV-negative people of the same age,HIV-positive people had thicker internal media thickness of the common carotid artery,larger internal diameter of the vertebral artery,slower PSV of the vertebral artery,and higher RI of the vertebral artery.The differences between groups were statistically signi-ficant(P<0.05),and were more significant in younger patients.[Conclusion]HIV-positive people with traditional CVD-related risk factors such as hypertension and hyperlipidemia had an increased risk of developing abnormal carotid arteries.The incidence of vertebral artery resistance index increased in smokers.The group with abnormal carotid artery and increased vertebral artery resistance index showed obvious immune activation.Younger HIV-positive people have a higher risk of cardiovascular disease than HIV-negative people,suggesting that HIV-positive people,especially young people,should be examined early with ultrasound of the cervical and vertebral arteries to detect abnormalities and intervene as soon as possible.