Peripheral Arterial Disease in HIV-Infected Patients: Atherosclerosis and Vasculitic Syndromes

  • P. Mercié
  • B. Le Bail
  • C. Cipriano


The various cardiovascular diseases observed in HIV-infected patients and widely described in the literature have been predominantly coronary and peripheral arterial diseases (PAD) and remain poorly known. Classically, PAD is expressed as two forms: atherosclerosis, defined as an atheromatous inflammatory disease, and vasculitic syndromes, known as non-atheromatous inflammatory diseases. The prevalence and severity of peripheral arterial atherosclerosis in HIV-infected patients remain, at the moment, poorly known mostly because study protocols failed to require that it and coronary arterial disease be dissociated. Several cases of vasculitic syndromes have been reported such as pseudonecrotizing polyangiitis, Kawasaki’s syndrome, Behçet’s disease, Henoch-Schönlein purpura, and essential mixed cryoglobulinemia in patients co-infected with HIV and hepatitis C virus, but they remain extremely rare.


Kawasaki Disease Peripheral Arterial Disease Protease Inhibitor Therapy Kawasaki Syndrome Vasculitic Syndrome 
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  1. 1.
    Bozette SA, Ake CF, Tam HK, Chang SW, Louis TA (2003) Cardiovascular and cerebrovascular events in patients treated for human immunodeficiency virus infection. N Engl J Med 348:702–710CrossRefGoogle Scholar
  2. 2.
    Friis-Møller N, Weber R, Reiss P et al (2003) Cardiovascular disease risk factors in HIV patients: association with antiretroviral therapy. Results from the DAD study. AIDS 17:1179–1193Google Scholar
  3. 3.
    The Data Collection on Adverse Events of AntiHIV Drugs (DAD) Study Group (2003) Combination antiretroviral therapy and the risk of myocardial infarction. N Engl J Med 349:1993–2003CrossRefGoogle Scholar
  4. 4.
    Mary-Krause M, Cotte L, Simon A, Partisani M, Costagliola D, and the Clinical Epidemiology Group from the French Hospital Database (2003) Increased risk of myocardial infarction with duration of protease inhibitor therapy in HIV-infected men. AIDS 17:2479–2486CrossRefPubMedGoogle Scholar
  5. 5.
    Savès M, Chêne G, Ducimetière P et al (2003) Risk factors of coronary heart disease in patients treated for human immunodeficiency virus infection compared with the general population. Clin Infect Dis 37:292–298CrossRefPubMedGoogle Scholar
  6. 6.
    Mercié P, Lavignolle V, Thiébaut R et al (2002) Evaluation of cardiovascular risk factors in HIV-1 infected patients using carotid intima-media thickness measurement. Ann Med 34:55–63CrossRefPubMedGoogle Scholar
  7. 7.
    Depairon M, Chessex S, Sudre P et al (2001) Premature atherosclerosis in HIV-infected individuals focus on protease inhibitor therapy. AIDS 15:329–334CrossRefPubMedGoogle Scholar
  8. 8.
    Maggi P, Lillo A, Perilli F et al, on behalf of the PREVALEAT Group (2004) Color Doppler ultrasonography of carotid vessels in patients treated with antiretroviral therapy: a comparative study. AIDS 18:1023–1028CrossRefPubMedGoogle Scholar
  9. 9.
    Hsue PY, Lo JC, Franklin A (2004) Progression of atherosclerosis as assessed by carotid intima-media thickness in patients with HIV infection. Circulation 109:1603–1608CrossRefPubMedGoogle Scholar
  10. 10.
    Mercie P, Thiebaut R, Aurillac-Lavignolle V et al (2005) Carotid intima-media thickness is slightly increased over time in HIV-1-infected patients. HIV Medicine 6:380–387CrossRefPubMedGoogle Scholar
  11. 11.
    Thiebaut R, Aurillac-Lavignolle V, Bonnet F et al (2005) Change in atherosclerosis progression in HIV infected patients: ANRS Aquitaine Cohort, 1999–2004. AIDS 19(7):729–731CrossRefPubMedGoogle Scholar
  12. 12.
    Currier JS, Kendall MA, Zackin R et al (2005) Carotid artery intima-media thickness and HIV infection: traditional risk factors overshadow impact of protease inhibitor exposure. AID 19:927–933CrossRefGoogle Scholar
  13. 13.
    Barbaro G (2003) HIV infection in the cardiovascular system: vasculitic syndromes in HIV-infected patients. Adv Cardiol 40:185–196CrossRefPubMedGoogle Scholar
  14. 14.
    Shingadia D, Das L, Klein-Gitelman M, Chadwick E (1999) Takayasu’s arteritis in a human immunodeficiency virus-infected adolescent. Clin Infect Dis 29:458–459CrossRefPubMedGoogle Scholar
  15. 15.
    Stein CM, Thomas JE (1991) Behçet’s disease associated with HIV infection. J Rheumatol 18:1427–1428PubMedGoogle Scholar
  16. 16.
    Mercie P, Viallard JF, Cipriano C et al (2002) Aphthous stomatitis in a patient with Behçet’s disease and HIV was associated with an increased HIV load. Clin Exp Rheumatol 20(Suppl. 26):S54PubMedGoogle Scholar
  17. 17.
    Buskila D, Gladman DD, Gilmore J, Saliut IE (1991) Behçet’s disease in a patient with immunodeficiency virus infection. Ann Rheum Dis 50:115–116CrossRefPubMedGoogle Scholar
  18. 18.
    Cooper LM, Patterson JA (1989) Allergic granulomatosis and angiitis of Churg-Strauss: case report in a patient with antibodies to human immunodeficiency virus and hepatitis B virus. Int J Dermatol 28:597–599CrossRefPubMedGoogle Scholar
  19. 19.
    Hall TN, Brennan B, Leahy MF, Woodroffe AJ (1998) Henoch-Schönlein purpura associated with human immunodeficiency virus infection. Nephrol Dial Transplant 13:988–990CrossRefPubMedGoogle Scholar
  20. 20.
    Gherardi R, Belec L, Mhiri C et al (1993) The spectrum of vasculitis in human immunodeficiency virus-infected patients: a clinicopathologic evaluation. Arthritis Rheum 36:1164–1174CrossRefPubMedGoogle Scholar
  21. 21.
    Font C, Miro O, Pedrol E et al (1996) Polyarteritis nodosa in human immunodeficiency virus infection: report of four cases and review of the literature. Br J Rheumatol 35:796–799CrossRefPubMedGoogle Scholar
  22. 22.
    Calabrese LH (1991) Vasculitis and infection with the human immunodeficiency virus. Rheum Dis Clin North Am 17:131–147PubMedGoogle Scholar
  23. 23.
    Libman BS, Quismorio FP, Jr, Stimmler MM (1995) Polyarteritis nodosa-like vasculitis in human immunodeficiency virus infection. J Rheumatol 22:351–355PubMedGoogle Scholar
  24. 24.
    Gisselbrecht M, Cohen P, Lortholary O et al (1997) HIV-related vasculitis: clinical presentation and therapeutic approach on six patients. AIDS 11:121–123PubMedGoogle Scholar
  25. 25.
    O’Grady NP, Sears CL (1996) Therapeutic dilemmas in the care of a human immunodeficiency virus-infected patient with vasculitis: case report. Clin Infect Dis 23:559–561Google Scholar
  26. 26.
    Porwancher RSS (1992) Adult Kawasaki disease in HIV-infected patients. 8th International Conference on AIDS, Amsterdam, 1992Google Scholar
  27. 27.
    Martinez-Escibano JA, Redondo C, Galera S et al (1998) Recurrent Kawasaki syndrome in an adult with HIV-1 infection. Dermatology 197:96–97Google Scholar
  28. 28.
    Wolf CV 2nd, Wolf JR, Parker JS (1995) Kawasaki’s syndrome in a man with the human immunodeficiency virus. Am J Ophthalmol 120:117–118PubMedGoogle Scholar
  29. 29.
    Porneuf M, Sotto A, Barbuat C, Ribou G, Jourdan J (1996) Kawasaki syndrome in an adult AIDS patient. Int J Dermatol 35:292–294CrossRefPubMedGoogle Scholar
  30. 30.
    Viraben R, Dupre A (1987) Kawasaki disease associated with HIV infection. Lancet 1:1430–1431CrossRefPubMedGoogle Scholar
  31. 31.
    Bayrou O, Philippoteau C, Artigou C et al (1993) Adult Kawasaki syndrome associated with HIV infection and anticardiolipin antibodies. J Am Acad Dermatol 29:663–664CrossRefPubMedGoogle Scholar
  32. 32.
    Yoganathan K, Goodman F, Pozniak A (1995) Kawasaki-like syndrome in an HIV-positive adult. J Infect 30:165–166CrossRefPubMedGoogle Scholar
  33. 33.
    Johnson RM, Little JR, Storch GA (2001) Kawasakilike syndromes associated with human immunodeficiency virus infection. Clin Infect Dis 32:1628–1634CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • P. Mercié
    • 1
  • B. Le Bail
    • 2
  • C. Cipriano
    • 3
  1. 1.Service de Médecine InterneHôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux et INSERM U593, Université Victor Segalen Bordeaux 2BordeauxFrance
  2. 2.Laboratoire d’AnatomophatologieHôpital Pellegrin, Centre Hospitalier Universitaire de BordeauxBordeauxFrance
  3. 3.Service de Médecine Interne et Maladies InfectieusesHôpital Haut-Lévêque, Centre Hospitalier Universitaire de BordeauxPessacFrance

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