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HIV Is Associated With Subclinical Coronary Atherosclerosis: A Prospective Matched Cohort Study

Andreas D Knudsen1,2, Andreas Fuchs2, Thomas Benfield3

  • 1Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|June 30, 2025
PubMed

Insights

People with HIV (human immunodeficiency virus) have a higher risk of coronary atherosclerosis, a condition where arteries harden. This study found HIV is independently linked to a three-fold increased risk of obstructive coronary atherosclerosis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Persons with HIV (PWH) face an increased risk of myocardial infarction.
  • Mechanisms linking HIV to elevated cardiovascular risk are not fully understood.
  • Subclinical coronary atherosclerosis may contribute to this disparity.

Purpose of the Study:

  • To compare the prevalence and characteristics of subclinical coronary atherosclerosis in PWH versus population controls.
  • To investigate the independent association between HIV infection and coronary atherosclerosis.

Main Methods:

  • Utilized data from the Copenhagen Comorbidity in HIV Infection and Copenhagen General Population studies.
  • Assessed coronary atherosclerosis using coronary computed tomography angiography.
  • Adjusted analyses for traditional cardiovascular risk factors.

Main Results:

  • Included 519 PWH and 1114 controls; median age 52, 89% male.
  • PWH showed higher prevalence of any (54% vs 42%) and obstructive (16% vs 8%) coronary atherosclerosis.
  • HIV was independently associated with 1.98-fold odds of any and 3.21-fold odds of obstructive atherosclerosis.

Conclusions:

  • HIV is independently associated with a significantly higher risk of subclinical obstructive coronary atherosclerosis.
  • Findings suggest subclinical atherosclerosis may explain increased myocardial infarction risk in PWH.
Abstract

Keywords:
HIVcardiovascular diseasecoronary computed tomography angiographycoronary plaquesubclinical coronary atherosclerosis

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