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Published on: January 12, 2016

Cardio- and cerebrovascular events in HIV-infected persons

A d'Arminio1, C A Sabin, A N Phillips

  • 1Università degli Studi di Milano, Italy.

AIDS (London, England)
|August 19, 2004
PubMed

Insights

Combination antiretroviral treatment (CART) significantly increases the risk of cardiovascular and cerebrovascular disease events (CCVE) in HIV patients. This risk elevation is comparable to the known impact of CART on myocardial infarction (MI).

Area of Science:

  • Cardiology
  • HIV Medicine
  • Epidemiology

Background:

  • Previous D:A:D Study data showed a 26% annual increase in myocardial infarction (MI) risk with combination antiretroviral treatment (CART).
  • The D:A:D Study is a large, international collaboration tracking HIV-infected patients.

Purpose of the Study:

  • To investigate if the risk of other cardio- and cerebro-vascular disease events (CCVE) is similarly increased by CART.
  • To assess the overall cardiovascular risk associated with CART in HIV patients.

Main Methods:

  • Prospective follow-up of 23,468 HIV-infected patients across 11 cohorts in Europe, USA, and Australia.
  • Defined CCVE as the first occurrence of acute MI, invasive cardiovascular procedures, stroke, or cardiovascular death.
  • Utilized Poisson regression models adjusted for known CCVE risk factors.

Main Results:

  • Over 36,145 person-years, 207 patients experienced a CCVE (23.7% fatal).
  • The incidence of first CCVE was 5.7 per 1000 person-years.
  • Each year of CART exposure increased CCVE risk by 26% (RR, 1.26; 95% CI, 1.14-1.38).

Conclusions:

  • Combination antiretroviral treatment (CART) demonstrably increases the risk of cardiovascular and cerebrovascular diseases (CCVD).
  • The risk increase for CCVD is comparable to that observed for myocardial infarction (MI).
  • Findings support the hypothesis that atherosclerosis may be a side-effect of CART.
Abstract

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