Association Between Erectile Dysfunction and Carotid Subclinical Atherosclerosis in HIV-Infected Patients. (1st April 2019)

• Record Type: Journal Article
• Authors: Bernal, Enrique; Torres, Marcos; Alcaraz, Antonia; Alcaraz, Maria Jose; Rosa, Vicente de la; Valero, Salvador; Muñoz, Angeles; Onteniente, María; Vicente, Tomas; Cano, Alfredo
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 80:Number 4(2019)
• Publication Date: 2019-04-01
• Subjects: erectile dysfunction -- subclinical atherosclerosis -- cardiovascular risk; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000001932
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: Erectile dysfunction (ED) is frequent in HIV-infected patients, and it can be associated with atherosclerosis and cardiovascular events. So, the objective was to evaluate whether the presence of moderate–severe ED was a marker of subclinical atherosclerosis (SCA) in HIV-infected patients. Methods: A cross-sectional study was conducted in a cohort of HIV-infected patients. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) questionnaire. The presence of SCA was determined by calculating the mean carotid intima–media thickness with Doppler ultrasound. A logistic regression analysis was performed to check the variables associated with SCA. Results: One hundred thirty-nine men of 45 (10) years of age were included, of which 130 (94.9%) received antiretroviral therapy. In 30 (22%) patients, the Framingham score was higher than 10%. In 36 (25.9%) patients, ED was detected in a moderate–severe degree and in 53 (38.1%), SCA was detected. In the multivariate analysis, variables independently associated with the presence of SCA were as follows: older age [odds ratio (OR) = 1.22, confidence interval (CI) 95%: 1.1 to 1.35, P < 0.001] and moderate–severe ED (OR = 4.68, CI 95%: 1.18 to 18.5; P = 0.028). Variables associated with moderate–severe ED were as follows: age (OR = 1.107, CI 95%: 1.041 to 1.17, P < 0.001) and having antibodies for hepatitis C virus (OR = 5.12, CI 95%: 1.54 to 17.03, P < 0.001). Conclusions: HIV-Infected patients often have moderate–severe ED, especially the elderly and coinfected patients with hepatitis C virus. ED can be an early clinical manifestation of incipient atherosclerosis, so its presence should involve a deep control of cardiovascular risk factors and using a regimen with a better atherogenic profile.