The primary objectives of this work were: (1) to describe trends in HIV prevalence among those undergoing carotid intervention (carotid endarterectomy or carotid artery stenting) in the United States; and (2) to determine if HIV infection is independently associated with symptomatic carotid atherosclerotic disease or age at the time of carotid intervention. In a nationally representative inpatient database from 2004 to 2014, HIV infection was associated with younger age at the time of carotid intervention (59 years [SE 0.2] vs 71 years [SE 0.01], p < 0.001), male sex (83% vs 58%, p < 0.001), black race (21% vs 4%, p < 0.001), and symptomatic carotid atherosclerotic disease (18.8% vs 11.0%, p < 0.001). Among those undergoing carotid intervention, there was a significant increase in the prevalence of HIV from 0.08% in 2004 to 0.17% in 2014 ( p < 0.001). After adjustment for patient demographics, comorbidities and other covariates, HIV infection remained significantly associated with younger age (–8.9 years; 95% CI: –9.7 to −8.1; p < 0.001) at the time of carotid intervention, but HIV infection was not independently associated with symptomatic carotid atherosclerotic disease.
Prevalence and Significance of Risk Enhancing Biomarkers in the United States Population at Intermediate Risk for Atherosclerotic Disease
