Lower CD4 Count Linked to Peripheral Artery Disease in People With HIV

Those who had a low CD4 count when diagnosed with the cardiovascular condition were also more likely to die within four years.

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People with HIV who have a lower CD4 count have a higher risk of peripheral artery disease compared with the HIV-negative population, aidsmap reports. Peripheral artery disease, which involves cholesterol buildup in arteries in the lower limbs, is the second most common form of cardiovascular disease after coronary artery disease.

Researchers in the Veterans Aging Cohort Study (VACS) examined the rate of diagnosis of peripheral artery disease in 29,291 veterans with HIV and 62,996 HIV-negative controls matched by age, race and sex.

Among those with HIV, the median CD4 count was 383 upon entry into the study, at which point 44 percent were taking antiretrovirals (ARVs).

After adjusting the data to account for differences in age, sex, race and cardiovascular risk factors, including LDL cholesterol, triglycerides, diabetes, smoking, hypertension, obesity, impaired kidney function, hepatitis C virus (HCV) and alcohol or cocaine abuse, the researchers found that people whose last CD4 count was between 200 and 499 had a 24 percent higher rate of peripheral artery disease compared with the HIV-negative population. Those HIV-positive people with a most recent CD4 count below 200 had a 73 percent higher rate of the cardiovascular condition compared with the controls. There was no significant difference in the rate of peripheral artery disease between those people with HIV who had a CD4 count of 500 or higher and the HIV-negative group.

The investigators found that adjusting the data to account for those who had a fully suppressed virus did not change the relationship between CD4 count and risk of peripheral artery disease.

Less than half of those who had a CD4 count below 200 when diagnosed with peripheral artery disease were still living four years later, compared with about three quarters of those with a CD4 count above 500 when diagnosed with the cardiovascular condition.

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