Cardiovascular disease-related mortality and factors associated with cardiovascular events in the TREAT Asia HIV...

Area of Science:

• Infectious Diseases
• Cardiology
• Public Health

Background:

• The aging HIV-positive population presents unique health challenges, with cardiovascular disease (CVD) emerging as a significant contributor to morbidity and mortality.
• Understanding CVD risk factors in this demographic is crucial for effective clinical management and public health strategies.

Purpose of the Study:

• To investigate the causes of death (CODs) in a multi-country Asian HIV-positive cohort, with a specific focus on CVD-related deaths.
• To identify factors associated with the development of fatal and nonfatal CVD events in individuals living with HIV.

Main Methods:

• Utilized data from the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD) from 2003-2017.
• Included patients on antiretroviral therapy (ART) with over one day of follow-up, analyzing cumulative incidences of various CODs and CVD events.
• Employed competing risk regression to assess risk factors for any CVD event.

Main Results:

• Out of 8069 patients, 378 deaths occurred, including 22 CVD-related deaths.
• Significant risk factors for CVD events included older age (≥51 years), high blood pressure, high total cholesterol, high triglycerides, and high body mass index (BMI).
• Crude incidence rates for CVD events were lower in later ART initiation periods and in middle-income countries.

Conclusions:

• Fatal and nonfatal CVD events in the HIV-positive cohort were associated with older age and modifiable risk factors like hypertension, dyslipidemia, and obesity.
• Lower CVD event rates in middle-income countries might suggest under-diagnosis in resource-limited Asian-Pacific settings, warranting further investigation.