September 15, 2000
The presentations for this session were also very good. James Stein from the University of Wisconsin presented data showing that the use of protease inhibitors is associated with endothelial dysfunction. He evaluated flow-mediated vasodilatation of the brachial artery in a cross-sectional analysis of 37 patients using high-resolution ultrasound. Patients on protease inhibitors had impaired FMD, which could be associated with an increased risk of cardiovascular complications down the road. The study was limited in all cross sectional studies. Longitudinal studies, before and after starting treatment, will provide better information, but is an important step in the right direction.
Renato Maserati from Pavia, Italy presented data demonstrating that carotid thickening is present in HAART-treated patients -- which is also a predictor of increased cardiovascular risk. Again, this was a cross-sectional study, which limits its scope, but both studies suggest that one can no longer ignore the cardiovascular risks associated with potent antiretroviral therapy (which was the point that Matthias Egger was making).