Introduction
AIDS, varicella zoster, NAFLD, NCD, fatty liver disease, cardiovascular disease, atherosclerotic disease, periodontitis, atherosclerotic, atherosclerosis, steatosis, VZV
VARICELLA ZOSTER, VIRUS, CYTOMEGALOVIRUS, CARDIOVASCULAR DISEASE, INFLAMMATION, AIDS, PERIODONTITIS, LIVER FIBROSIS, DYSFUNCTION, SECONDARY, INSULIN RESISTANCE, VASODILATATION, NON-ALCOHOLIC FATTY LIVER DISEASE, ATHEROSCLEROSIS, STEATOSIS, DYSLIPIDEMIA
Highly active antiretroviral therapy (HAART) has contributed to significant reduction in AIDS related morbidity and mortality in HIV-infected patients
There is accumulated evidence that some infectious agents, such as cytomegalovirus (CMV) and varicella zoster virus (VZV), may accelerate the course of atherosclerotic disease in HIV-infected patients
Subclinical atherosclerosis has been described in several studies on HIV-infected patients but no special treatment has been confirmed yet. There are some traditional and non-traditional factors that may contribute to the acceleration of atherosclerotic process in HIV patient, such as dyslipidemia, ART-related dyslipidemia, and HIV-associated immune activation and inflammation.Carotid intima media thickness (CIMT) is known to be the surrogate marker for subclinical atherosclerosis
Besides CIMT, FMD has also gained more attention in recent years despite its tight procedure. Flow-mediated dilatation describes any vasodilatation of an artery following an increase in luminal blood flow and internal-wall shear stress
Several studies have linked cardiovascular disease with oral inflammation, including periodontitis in the general population. However, its underlying mechanisms and cause-effect relationship remain unclear
Non-alcoholic Fatty Liver Disease (NAFLD), another NCD that is common in HIV-infected patients, is also closely related to cardiovascular disease through different immune and metabolic processes. Patients with fatty liver disease are present with increased visceral adipose tissue (AT) secondary to inadequate intake of food. This causes a dysfunction in the AT generating insulin resistance, thereby increasing lipolysis and resulting in a greater release of free fatty acids (FFAs) into the bloodstream
Statins, which were first extracted from
We conduct a randomized double-blind placebo-controlled trial that primarily aims to evaluate the effect of atorvastatin on carotid intima media thickness (CIMT) in virally-suppressed HIV-infected patients with CMV seropositivity. Secondly, this trial also evaluates the other marker values, such as FMD, liver fibrosis and steatosis, fasting lipid, neurocognitive test, CPI, and residual immune activation as secondary outcome for 48 weeks.