Ankle-branch index and HIV: the role of antiretrovirals.

Objective To study the relationship between antiretroviral (ARV) treatment and abnormal ankle–branch index (ABI) and to compare the risk factors for altered ABI. Methods Patients coming to the office from April 2007 until July 2007 were offered the chance to take part in the study. ABI was obtained by the standard technique. Those ≤0.9 or ≥1.3 were considered altered ABI. Clinical reports were reviewed to examine traditional vascular risk factors, coinfection with hepatitis C virus and/or hepatitis B virus, tobacco use, highly active antiretroviral therapy use and its components and length of use of each ARV drug. Results ABI was measured in 147 patients, 82.3% males. Thirty-three patients (22.45%) had an altered ABI, and it was related to CD4 cell nadir, dyslipidaemia and protease inhibitor (PI) use. When logistic regression was carried out, only dyslipidaemia (OR 2.68, CI 95%: 1.06–6.91) and PI use (OR 2.79, CI 95%: 1.15–6.54) remained in the model. Conclusions Altered ABI is associated with PI use independently of dyslipidaemia. Probably, it marks patients with high vascular risk not identified with traditional scales.