Objectives: to preliminarily describe the clinical features and management
of arterial occlusive disease in human immunodeficiency virus (HIV) infecte
Materials: twenty HIV positive patients with symptomatic large-vessel arter
ial occlusion treated by a tertiary vascular unit in a 3-year period.
Methods: retrospective review of clinical case records.
Results: patients were noted to be young (median age 37 years), with prepon
derance of males. Twelve patients had evidence of advanced HIV infection. A
ll patients had critical ischaemia, involving the upper limbs in four and t
he lower limbs in 16. Coagulation abnormalities were noted in two cases. Op
erative intervention in 18 patients included revascularisation in seven. Th
rombotic occlusion of normal-looking arteries was noted. Arterial biopsy re
vealed leucocytoclastic vasculitis indicative of HIV arteritis in three of
five cases examined.
Conclusions: initial experience with large-vessel occlusive disease in HIV
positive patients suggests an underlying arteritic aetiology, with clinical
and pathological features distinct from atherosclerosis. Further in-depth
study is necessary to clarify the pathophysiological basis thereof.