HIV-infected inpatients in the HAART era: how do hepatitis C virus coinfected patients differ?

We compared the demographics and clinical characteristics of HIV-infected patients with and without hepatitis C virus (HCV) coinfection hospitalized at Cook County Hospital, Chicago, Illinois, from October 1999 through September 2000. Two hundred three (40%) of the 510 patients were coinfected with HCV. HCV coinfected patients were less likely to be on highly active antiretroviral therapy (HAART) and were frequently hospitalized with higher CD4 counts for non-HIV-related medical problems including complications of liver disease.

Electron beam computed tomography for assessment of coronary artery disease in HIV-infected men receiving antiretroviral therapy.

Hyperlipidemia has been seen in patients receiving protease inhibitor-based antiretroviral therapy, prompting concern that such patients are at risk for accelerated coronary artery disease (CAD). To assess the risk of CAD in antiretroviral-treated HIV-infected men, we quantified coronary artery calcium (CAC), a sensitive and established marker of subclinical CAD, using electron beam computed tomography (EBCT) of coronary vessels. Sixty HIV-infected men who met the following criteria (cases) were enrolled in the study: age of 40 years or older; naive to antiretroviral therapy or use of a stable antiretroviral regimen for >or=6 months (mean duration, 25.9 months; 41 patients were receiving protease inhibitor therapy); and no known CAD or no use of lipid-lowering agents. EBCT-derived CAC scores, serum lipid levels, history of antiretroviral therapy, and risk factors for CAD were obtained. Each case was compared with three age-, sex-, and race-matched HIV-negative controls randomly selected from a database including >9000 patients who had undergone EBCT. We determined differences in the proportion of cases and controls with CAC scores of >0 (detectable calcium) and clinically significant CAC for age range. There were no statistically significant differences between the number of cases and controls with detectable CAC (33% and 39%, respectively) and clinically significant CAC (18% and 17%, respectively). This study suggests that the rate of coronary atherosclerosis among HIV-infected patients who receive short-term antiretroviral therapy with or without protease inhibitors is not higher than that among age-, sex-, and race-matched HIV-negative controls. These results need to be confirmed in larger long-term studies, with controls well matched for coronary risk factors.