The prevalence of and risk factors for peripheral arterial occlusive disease in human immunodeficiency virus-infected omani patients: The first study in GCC

• Main Authors: Ahmed Al-Aufi, Khalifa Al-Wahaibi, Edwin Stephen, Abdullah Balkhair, Ibrahim Abdelhedy, Hanan Al-Maawali
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Indian Journal of Vascular and Endovascular Surgery
• Subjects: ankle–brachial pressure index; arterial; asymptomatic arterial disease; cd4; laudication; gulf cooperation council; human immunodeficiency virus; immunodeficiency; oman; peripheral arterial occlusive disease; prevalence; vascular
• Online Access: http://www.indjvascsurg.org/article.asp?issn=0972-0820;year=2020;volume=7;issue=2;spage=125;epage=128;aulast=Al-Aufi

Aim: To assess the prevalence of peripheral arterial occlusive disease (PAOD) in human immunodeficiency virus (HIV)-infected Omani patients and to assess the potential risk factors in this group. Methodology: This was a single-center, cross-sectional study. All patients attending the infectious disease clinic between July 2017 and March 2018 were included in the study; their peripheral pulses were examined and pre- and postexercise ankle–brachial pressure index (ABPI) was measured. Normal ABPI was considered as being in the range of 1.0 ± 0.1, and a reduction of >15% postexercise ABPI was considered as a cutoff limit to define PAOD. The Edinburgh Claudication Questionnaire was answered by all patients, and CD4 count, viral load, albumin and Vitamin D (25-OH) levels, and glycated hemoglobin (HbA1c) were measured. The data were analyzed using IBM SPSS Statistics version 22. Results: Eighty-eight patients who were retroviral positive were enrolled in the study. Fifty-three (60.2%) patients were male and 35 (39.8%) were female, with a mean age of 43 years (24–71). The dorsalis pedis artery pulsation was absent bilaterally in 3 (3.4%) patients. None of the patients had a history of claudication; 1 (1.1%) had an abnormal ABPI; 17 (19.2%) had a reduction of >15% postexercise ABPI; 7 (8%) had CD4 count <200; 4 (4.5%) had detectable viral load; albumin level was <25 g/L in 5 (5.8%); 15 (17%) had Vitamin D (25-OH) <50 nmol/L; and 4 (4.5%) had an abnormal HbA1c. Conclusions: The prevalence of PAOD in HIV-infected patients is higher compared to the general population as was evident from an abnormal postexercise ABPI. Risk factors that stood out while not having a significant P- value were low values of CD4 counts and Vitamin –D levels.