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Coronary heart disease in HIV-infected individuals
Judith S Currier1, Anne Taylor, Felicity Boyd
1David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California 90095, USA. jscurrier@mednet.ucla.edu
Insights
Individuals with HIV infection face a higher risk of coronary heart disease (CHD), particularly younger adults. Antiretroviral therapy (ART) was associated with increased CHD risk in young HIV patients, suggesting integrated CHD prevention in HIV care.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Public Health
Background:
- The relationship between Human Immunodeficiency Virus (HIV) infection and coronary heart disease (CHD) risk remains unclear.
- The specific impact of antiretroviral therapy (ART) on CHD development in HIV patients has not been fully quantified.
Purpose of the Study:
- To investigate the incidence and relative risk (RR) of CHD in HIV-infected versus uninfected individuals.
- To assess the association between ART exposure and CHD incidence within the HIV-positive population.
Main Methods:
- Analysis of administrative claims data from the California Medicaid population.
- Comparison of CHD incidence and RR between HIV-infected and uninfected cohorts using log-linear regression.
- Stratified analysis to evaluate ART exposure and CHD association across different age groups.
Main Results:
- A significantly higher incidence of CHD was observed in younger HIV-infected men (up to age 34) and women (up to age 44) compared to their non-HIV-infected counterparts.
- Among HIV-infected individuals aged 18-33 years, ART exposure was linked to a 2.06-fold increased risk of CHD (P < 0.001).
- No significant association between ART and CHD was found in other age demographics.
Conclusions:
- Coronary heart disease incidence appears accelerated in young individuals living with HIV.
- Cardiovascular risk reduction strategies should be integrated into the primary care of patients with HIV.
- Further research may be warranted to explore mechanisms and long-term cardiovascular outcomes in HIV patients on ART.
Abstract:
It is currently unknown whether there is an increased risk of coronary heart disease (CHD) in patients with HIV infection. In addition, the contribution of antiretroviral therapy (ART) to CHD risk has not been quantified. We reviewed administrative claims data for HIV-infected and -uninfected individuals from the California Medicaid population and compared the incidence of and relative risk (RR) for CHD using log-linear regression analyses between groups. The association between exposure to ART and CHD incidence was also assessed. Of 3,083,209 individuals analyzed, 28,513 were HIV-infected. The incidence of CHD among young men (up to age 34) and women (up to age 44) with HIV infection was significantly higher than that among non-HIV-infected individuals. The covariate-adjusted RR for the development of CHD in individuals receiving ART compared with those not receiving ART was 2.06 (P < 0.001) in HIV-infected individuals aged 18-33 years. There were no statistically significant associations between ART exposure and CHD in other age groups. CHD incidence appears accelerated among young HIV-infected individuals. Strategies to reduce CHD risk should be incorporated into HIV primary care.