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Background  Adults infected with  HIV  have increased atherosclerosis potentially associated with both  HIV  and non‐ HIV  associated factors. We characterized risk factors for atherosclerosis as measured by noninvasive vascular imaging.    Methods and Results  We used B‐mode ultrasound to examine levels and correlates of echogenicity and vessel wall thickness of the carotid artery intima‐media complex in 1282  HIV ‐infected and 510  HIV ‐uninfected women of the Women's Interagency  HIV  Study. Levels of gray scale median ( GSM , a measure of echogenicity) did not vary between  HIV  infection groups. In both groups, smokers had increased  GSM , whereas age, diabetes, elevated blood pressure, and high  BMI  were associated with lower (rather than higher)  GSM . Each of these non‐lipid  CVD  risk factors, especially age and blood pressure, was also associated with higher levels of carotid artery intima‐media thickness ( cIMT ). Higher serum triglyceride levels were associated with lower  GSM  in both  HIV ‐infected and  HIV ‐uninfected groups. Additional lipid risk factors for low  GSM  including high LDL cholesterol and low HDL cholesterol levels were identified in  HIV  uninfected but not in  HIV  infected women. In contrast to findings for  GSM , among the lipid parameters only LDL cholesterol level had an association with  cIMT , which was observed only in the  HIV  uninfected group.    Conclusions  Lipid and non‐lipid risk factor associations with echolucency of the carotid artery and the thickness of the common carotid artery intima‐media layer suggest that these measures capture different aspects of atherosclerosis.

journal of the american heart association

Echolucency of the Carotid Artery Intima‐Media Complex and Intima‐Media Thickness Have Different Cardiovascular Risk Factor Relationships: The Women's Interagency  HIV  Study