What makes you think that you cannot estimate CVD risk in this population?

In fact, people have tried, and with positive results (though they only compared with Framingham which does tend to perform less well than the SCORE function (admission - I was one of the original developers of SCORE).

So the first two statements you make suggest that you need to start with a decent literature search of your chosen area

http://cpr.sagepub.com/content/17/5/491.short

There is no sufficient evidence that HIV significantly alters Coronary Risk. The Framing-ham score therefore is a good estimate. Looks like more studies may be necessary to show that people with HIV need a different score for Coronary Risk. Read Durand et al J Acquir Immune Defic Syndr Volume 57, Number 3, July 1, 2011 and pay a keen attention to how they conclude.

Hello dear researchers,

I'm basing my theory in this article: "Cardiovascular disease risk assessment tools in HIV-infected patients - are they adequate? - J AIDS Clin Res. 2016 7:6.

Furthermore, the HIV infection and the HAART drugs leads to an increase risk of atherosclerosis development and this way, the cardiovascular diseases are the principal causes of death in HIV infected people. This way, we observe a vicious circle (HIV necessarily leads to the use of HAART and the drug leads to the cardiovascular disease).

My final point is: Framigham risk score is usefull to estimate the cardiovascular disease in this population? Is it necessary to development a different questionnary ?

Thanks Mr. Zeneti H.R. for your observation. I stand to be corrected but from the studies I have gone through, it seems that HAART mainly contributes to increased PREVALENCE and not INCIDENCE of CVDs and this is due to the sheer fact that they increase patient lifespan and this is good. HAART has so many advantages like treatment as prevention (reducing infectiousness) , preventing OIs, prolonging life etc. The risk we run by withholding HAART is far much higher than the benefits we stand to accrue from the same. This is the call of judgement that we have to make in any therapeutic adventure. Thanks to all

Cardiovascular risk assessment in HIV-infected male patients: a comparison of Framingham, SCORE, PROCAM and DAD risk equations.

Pirš M1, Jug B2, Eržen B2, Šabović M2, Karner P3, Poljak M4, Tomažič J3.

Author information

Abstract

INTRODUCTION:

Traditional cardiovascular (CVD) risk assessment algorithms such as the Framingham Risk Score (FRS), Systematic Coronary Risk Evaluation (SCORE) and Prospective Cardiovascular Munster (PROCAM) were developed for general populations, their usefulness in HIV-infected population has not been confirmed. DAD algorithm was developed specifically for HIV-infected patients. The aim of our study was to evaluate the performance of risk assessment algorithms in HIV-infected population.

METHODS:

A prospective cross-sectional national study that included 83 HIV-infected male patients from Slovenia below the age of 55 was performed. CVD risk was assessed using four algorithms, the presence of subclinical atherosclerosis was determined by measuring carotid intima-media thickness (CIMT); patients were followed up for 5 years.

RESULTS:

High proportion of patients with low CVD risk according to FRS (61.9%) and PROCAM (81.0%) and only 7.1% according to SCORE had evidence of subclinical atherosclerosis. Only 7.1% of patients with low CVD risk according to DAD algorithm had evidence of subclinical atherosclerosis.

CONCLUSION:

Our study has shown that SCORE and DAD algorithm were superior to FRS and PROCAM. In younger HIV-infected patients, even with moderate CVD risk, CIMT assessment should be employed in a complete clinical evaluation as a more aggressive prevention and treatment approach is warranted.

https://www.ncbi.nlm.nih.gov/pubmed/25242159