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Associations between HIV viremia during antiretroviral therapy and cardiovascular disease

Olof Elvstam1,2, Gaetano Marrone3, Gunnar Engström4

  • 1Department of Translational Medicine, Lund University, Malmö.

AIDS (London, England)
|June 22, 2022
PubMed

Insights

Higher HIV viremia exposure during antiretroviral therapy (ART) increases cardiovascular disease (CVD) risk. Low-level viremia showed no increased CVD risk compared to viral suppression in HIV patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Antiretroviral therapy (ART) has transformed HIV management, but cardiovascular disease (CVD) remains a significant concern.
  • Understanding the impact of HIV viremia on CVD risk in patients on ART is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To investigate the association between HIV viremia exposure during ART and the risk of developing cardiovascular disease (CVD).

Main Methods:

  • A nationwide observational cohort study using the Swedish InfCareHIV register (1996-2017).
  • Participants were categorized by viremia levels (suppression, low-level, high-level) and cumulative viremia exposure.
  • Proportional subhazard models were used to analyze CVD risk, accounting for competing risks.

Main Results:

  • Higher cumulative HIV viremia exposure was significantly associated with an increased risk of CVD.
  • High-level viremia (≥1000 copies/ml) demonstrated a 45% increased CVD risk compared to viral suppression.
  • No significant association was found between low-level viremia and CVD risk.

Conclusions:

  • Elevated HIV viremia exposure during ART is linked to a higher risk of CVD in patients.
  • Low-level viremia does not appear to elevate CVD risk compared to viral suppression.
  • Further research is needed to confirm causality due to the observational nature of the study.
Abstract

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