Heart Failure Risk and Events in People With HIV: The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE)

Area of Science:

• Cardiology
• Infectious Diseases
• Epidemiology

Background:

• People with HIV (PWH) have increased heart failure (HF) risk from traditional and HIV-related factors.
• HF incidence and risk prediction in PWH require further characterization.
• This study quantifies HF event risk in a global PWH cohort with low-to-moderate cardiovascular disease risk.

Purpose of the Study:

• To determine the incidence of heart failure (HF) events in people with HIV (PWH).
• To identify demographic, clinical, and HIV-specific factors associated with HF risk in PWH.
• To evaluate the consistency of observed HF events with predicted risk scores in PWH.

Main Methods:

• Analysis of 7769 participants from the REPRIEVE trial across 5 global regions.
• HF events were adjudicated through hospitalization records and standardized queries.
• HF incidence was calculated per 1000 person-years and stratified by various factors.

Main Results:

• HF incidence was 1.65 per 1000 person-years.
• Higher HF incidence observed in women, Black participants in high-income regions, those in sub-Saharan Africa, and individuals with hypertension or obesity.
• CD4+ T-cell count and HIV-1 RNA levels were not associated with HF incidence.
• Observed HF events (n=67) were consistent with predicted events (n=73) based on the Predicting Risk of Cardiovascular Disease Events HF score.

Conclusions:

• Demographics, clinical factors, and geographic region significantly influence HF incidence in PWH.
• The overall observed number of HF events in PWH aligns with predicted risk rates, validating risk assessment tools.