0%). The Framingham equation predicted a higher cardiovascular risk compared with the Rama-EGAT and D:A:D equations, which

seemed to agree relatively well. Only d4T use was marginally associated with a high Rama-EGAT score; longer ART duration and current viral suppression were significantly associated with a high Framingham score. The low predicted cardiovascular risk in our cohort can probably be explained by the similarly low prevalence of cardiovascular risk factors. A low prevalence of cardiovascular risk factors in a Thai population was previously described in the EGAT study [7], although the data were collected over 20 years ago. The prevalences of hypertension, hypercholesterolaemia, diabetes and smoking in a similarly aged (mean Alectinib in vivo 43 years) group of HIV-uninfected Thais in 1985 were 18, 32, 6 and 42%, respectively, compared with 13, 24, 7 and 13% in the present study. The lower prevalence of risk factors in our study may reflect BAY 73-4506 manufacturer under-diagnosis (hypertension), undocumented treatment (hypercholesterolaemia), the effect of smoking cessation campaigns, and the lower proportion of male subjects. CHD was an important cause of death in the EGAT cohort (28 of 165 deaths over 12 years of follow-up); the overall prevalence

was not reported. To our knowledge, this is the first study to evaluate the Rama-EGAT and D:A:D equations in an HIV-infected Asian population. The Rama-EGAT Heart Score comes from the EGAT study, which followed 3499 HIV-uninfected Thais aged 35 to 54 years employed at the EGAT from 1985 to 1997 [7,10]. The risk equation published by the D:A:D Study Group was derived from a data set of 22 625

HIV-infected subjects in 20 countries across Europe and Australia [11]. That the cardiovascular risks predicted by these equations agreed relatively well suggests that HIV-infected Thai individuals may not be at increased risk for CVD compared with those without HIV infection. Furthermore, the lack of statistically significant associations between HIV-related factors and high Rama-EGAT scores suggests that traditional cardiovascular risk factors may be interpreted similarly in HIV-infected and uninfected populations, a conclusion also drawn from the D:A:D study [11]. Rama-EGAT risks were, in fact, slightly higher than D:A:D risks; this may be explained by the broader cardiovascular outcome definition used in the Rama-EGAT Galeterone equation (MI or invasive coronary procedure in Rama-EGAT vs. only MI in D:A:D). This study has several limitations. First, cardiovascular risk data were obtained by physicians using a form with open-ended questions, allowing misinterpretations. ART histories were complex because of treatment changes and interruptions. Lipodystrophy was not defined by standardized criteria; however, it was assessed by experienced physicians at HIV-NAT with most subjects having at least one obvious sign (i.e. facial or buttock fat loss, increased abdominal girth, or prominent veins).