Association Between Erectile Dysfunction and Carotid Subclinical Atherosclerosis in HIV-Infected Patients

BACKGROUND:Erectile dysfunction (ED) is frequent in HIV-infected patients, and it can be associated with atherosclerosis and cardiovascular events. So, the objective was to evaluate whether the presence of moderate–severe ED was a marker of subclinical atherosclerosis (SCA) in HIV-infected patients. METHODS:A cross-sectional study was conducted in a cohort of HIV-infected patients. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) questionnaire. The presence of SCA was determined by calculating the mean carotid intima–media thickness with Doppler ultrasound. A logistic regression analysis was performed to check the variables associated with SCA. RESULTS:One hundred thirty-nine men of 45 (10) years of age were included, of which 130 (94.9%) received antiretroviral therapy. In 30 (22%) patients, the Framingham score was higher than 10%. In 36 (25.9%) patients, ED was detected in a moderate–severe degree and in 53 (38.1%), SCA was detected. In the multivariate analysis, variables independently associated with the presence of SCA were as followsolder age [odds ratio (OR) = 1.22, confidence interval (CI) 95%1.1 to 1.35, P < 0.001] and moderate–severe ED (OR = 4.68, CI 95%1.18 to 18.5; P = 0.028). Variables associated with moderate–severe ED were as followsage (OR = 1.107, CI 95%1.041 to 1.17, P < 0.001) and having antibodies for hepatitis C virus (OR = 5.12, CI 95%1.54 to 17.03, P < 0.001). CONCLUSIONS:HIV-Infected patients often have moderate–severe ED, especially the elderly and coinfected patients with hepatitis C virus. ED can be an early clinical manifestation of incipient atherosclerosis, so its presence should involve a deep control of cardiovascular risk factors and using a regimen with a better atherogenic profile.