{
  "abstract": "Background People living with HIV (PWH) are at increased risk of cardiovascular disease; however, evidence from Asian populations remains limited. We evaluated the prevalence and characteristics of carotid plaques among PWH and people without HIV (PWoH) in China to examine the impact of HIV infection on subclinical atherosclerosis.Methods In this cross-sectional study conducted at the Shanghai Public Health Clinical Center, China, we enrolled 1390 PWH and 1390 age-frequency and sex-frequency matched PWoH aged 40 years or older. Carotid ultrasonography was used to assess the presence, number and echogenicity of carotid plaques.Results The prevalence of carotid plaques was significantly higher in PWH than in PWoH (45.3% vs 37.5%, p<0.001), and the prevalence of echo-lucent plaques was also higher (21.1% vs 18.0%, p=0.045). Among participants with carotid plaques, PWH were more likely to have three or more plaques (35.8% vs 21.2%, p<0.001) and a greater maximum plaque thickness (2.0 mm vs 1.9 mm; p=0.026). After adjustment for age, sex and dyslipidaemia, HIV infection remained independently associated with increased odds of carotid plaques (adjusted OR (aOR)=1.45; 95% CI 1.23 to 1.70) and echo-lucent plaques (aOR=1.24; 95% CI 1.02 to 1.50). Associations were strongest among men and younger participants. No HIV-related clinical factors were significantly associated with carotid plaque presence.Conclusion HIV infection is independently associated with an increased carotid plaque burden and echo-lucent plaque features, suggesting accelerated atherosclerosis beyond traditional risk factors. These findings support routine cardiovascular risk assessment and early preventive strategies in PWH.",
  "authors": [
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China",
        "Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China"
      ],
      "name": "Xiaomeng Li"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Li Liu"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Jun Chen"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Jie Cao"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Zhenyan Wang"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Tangkai Qi"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Jianjun Sun"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Junyang Yang"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Shuibao Xu"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Wei Song"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Yueming Shao"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Youming Chen"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Yang Tang"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Jiangrong Wang"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Lin Wang"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Jiawei Huang"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Kaixing Wang"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Meiyan Sun"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Yiping Jin"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Zhen Zeng"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China",
        "Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China"
      ],
      "name": "Zihui Zhao"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Renfang Zhang"
    },
    {
      "affiliations": [
        "School of Public Health, Fudan University, Shanghai, China"
      ],
      "name": "Yingying Ding"
    },
    {
      "affiliations": [
        "Shanghai Public Health Clinical Center, Fudan University, Shanghai, China"
      ],
      "name": "Yinzhong Shen"
    }
  ],
  "title": "HIV infection is independently associated with carotid plaque burden and echogenic characteristics",
  "uid": "78542735-8424-504d-a592-c754b744f0e8"
}