Introduction: Increased cardio-vascular risk in HIV patients in antiretroviral therapy (ART) may be due to HIV infection, direct effect of ART or dyslipidemia induced by ART. Our aim was to study the relative importance of HIV, ART and dyslipidemia on atherosclerosis as measured by carotid artery intima-media thickness (IMT). To do so, we compared IMT in non-smoking HIV patients with high or low serum cholesterol levels as well as in healthy volunteers.

Methods: HIV patients in ART with normal (⩽5.5 mmol/L; n = 13) or high cholesterol (⩾6.5 mmol/L; n = 12) as well as healthy controls (n = 14) were included. All were non-smokers and had never received medication for dyslipidemia or hypertension. IMT was measured by ultrasonography.

Results: IMT in HIV patients with hypercholesterolemia (⩽5.5 mmol/L), HIV patients with normal cholesterol (⩾6.5 mmol/L) and controls was 683±119, 656 ±99 and 657±99 μm, respectively. IMT was similar in patients receiving and not receiving protease inhibitors (658±117 vs. 687±97 μm). IMT in HIV patients correlated inversely with HDL-cholesterol levels (r = −0.50; p = 0.01), whereas no correlation was found with total cholesterol or LDL-cholesterol.

Conclusions: In non-smoking HIV patients receiving ART no sign of accelerated artherosclerosis as assessed by IMT were found even if patients were hypercholesterolemic. IMT correlated with HDL- but not LDLcholesterol further indicating that reduction in cardio-vascular risk in these patients probably mainly should be aimed at reducing traditional risk factors rather than lipid lowering with statins.