Large-vessel vasculitis in human immunodeficiency virus-infected patients
Autor: | Marc Antoine Valantin, Fabien Koskas, David Saadoun, Philippe Cluzel, Nirvana Sadaghianloo, Patrice Cacoub, Julien Gaudric, Léa Savey, Yasmina Ferfar, Marlène Garrido, Pierre Fouret, Valérie Pourcher-Martinez, Fanny Domont, Cloé Comarmond, Laurent Chiche |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male Paris medicine.medical_specialty Time Factors medicine.medical_treatment HIV Infections Revascularization Antiviral Agents Gastroenterology Young Adult 03 medical and health sciences 0302 clinical medicine Recurrence Internal medicine Large vessel vasculitis medicine.artery Humans Medicine Young adult Glucocorticoids Aortitis Retrospective Studies 030203 arthritis & rheumatology Aorta business.industry Retrospective cohort study Middle Aged Viral Load medicine.disease Takayasu Arteritis CD4 Lymphocyte Count Treatment Outcome Female Surgery Cardiology and Cardiovascular Medicine business Vasculitis Viral load Immunosuppressive Agents 030217 neurology & neurosurgery |
Zdroj: | Journal of Vascular Surgery. 67:1501-1511 |
ISSN: | 0741-5214 |
Popis: | Objective The objective of this study was to describe large-vessel vasculitis (LVV) in patients with human immunodeficiency virus (HIV) infection. It is a retrospective single-center study conducted between 2000 and 2015 through a university hospital of 11 HIV-infected patients with LVV. Methods The characteristics and outcome of 11 HIV-infected patients with LVV (7 patients fulfilled international criteria for Takayasu arteritis, 5 patients had histologic findings of vasculitis, and 5 patients had imaging features of aortitis) were analyzed and compared with those of 82 patients with LVV but without HIV infection. Results Concerning the HIV-infected patients with LVV (n = 11), the mean age was 40 years (range, 36-56 years), and 55% of patients were female. At diagnosis of LLV, the mean initial CD4 cell count was 455 cells/mm 3 (range, 166-837 cells/mm 3 ), and the median HIV viral load was 9241 copies. Vascular lesions were located in the aorta (n = 7), in supra-aortic trunks (n = 7), and in digestive arteries (n = 3). Inflammatory aorta infiltrates showed a strong expression of interferon-γ and interleukin 6. In HIV-negative LVV patients (n = 82), the median age was 42 years, and 88% of the patients were women. Thirty patients had an inflammatory syndrome. Seventy patients had been treated with glucocorticosteroids and 57 with immunosuppressive treatments. Compared with their negative counterparts, HIV-positive patients with LVV were more frequently male ( P = .014), had more vascular complications (ie, Ishikawa score; P = .017), and had more frequent revascularization ( P = .047). After a mean follow-up of 96 months, four relapses of vasculitis were reported, and one patient died. Regardless of the HIV virologic response, antiretroviral therapy improved LVV in only one case. Conclusions LVV in HIV-infected patients is a rare and severe entity. |
Databáze: | OpenAIRE |
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