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Mortality After Acute Coronary Syndrome in Human Immunodeficiency Virus Infection with Optimal Adherence: A

Hyemin Jung1, Eunyoung Lee2, Jun-Soo Ro1

  • 1Department of Health Policy and Management, College of Medicine, Seoul National University, Seoul, Korea.

Infection & Chemotherapy
|November 28, 2023
PubMed

Insights

People with HIV (PWH) on antiretroviral therapy (ART) have a higher risk of acute coronary syndrome (ACS). However, mortality after ACS is similar to the general population when ART adherence is optimal.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Few studies examine acute coronary syndrome (ACS) outcomes in human immunodeficiency virus (HIV) patients on contemporary antiretroviral therapy (ART).
  • Generalized ART use and viral suppression are common in people with HIV (PWH).

Purpose of the Study:

  • To assess mortality following atherosclerotic cardiovascular events (ACS) in PWH with optimal ART adherence.
  • To compare ACS incidence and outcomes between PWH and the general population.

Main Methods:

  • Utilized Korean National Health Insurance claims data (2009-2019).
  • Identified newly diagnosed PWH and assessed ART adherence.
  • Confirmed ACS and mortality in PWH with optimal adherence.

Main Results:

  • ACS incidence was 1.3 times higher in PWH with optimal ART adherence compared to the general population.
  • Associated factors for ACS in PWH included AIDS, hypertension, dyslipidemia, and diabetes.
  • Overall mortality after ACS was 7.1% (2.9% for myocardial infarction), comparable to the general population.

Conclusions:

  • PWH maintaining optimal ART adherence exhibit higher ACS prevalence.
  • Mortality post-ACS in PWH on optimal ART is comparable to HIV-negative individuals.
Abstract

Keywords:
Anti-retroviral agentsEpidemiologyHIVInsurance claim reviewMyocardial infarction

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