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Prevalence and risk of cardiovascular events among people living with HIV: a meta-analysis

Shuqing Jin1,2, Hongfei Liu3, Xiyuan Song1

  • 1AIDS Clinical Research Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Henan, China.

Annals of Medicine
|July 21, 2026
PubMed

Insights

People living with HIV face significant cardiovascular risks from both traditional and HIV-specific factors. Prioritizing early risk assessment, viral suppression, and immune recovery is crucial for managing these events in this population.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • People living with HIV (PLWH) exhibit elevated cardiovascular disease (CVD) risk.
  • The specific contribution of HIV-related factors to overall CVD events remains incompletely understood.
  • This study aimed to clarify the prevalence and determinants of cardiovascular events in PLWH.

Purpose of the Study:

  • To determine the prevalence of cardiovascular events in people living with HIV (PLWH).
  • To identify traditional and HIV-specific risk factors associated with cardiovascular events in PLWH.
  • To explore subtype-specific risk profiles for different cardiovascular events.

Main Methods:

  • A systematic review and meta-analysis of observational studies was conducted.
  • Studies were identified through comprehensive searches of major biomedical databases (PubMed, EMBASE, Cochrane, Web of Science, Scopus) from 2004 to 2024.
  • Pooled relative risks and prevalence were calculated, with heterogeneity assessed using standard statistical methods.

Main Results:

  • Analysis of 43 studies involving over 4 million PLWH revealed a 6% prevalence of cardiovascular events.
  • Key risk factors included older age, smoking, antiretroviral therapy, male sex, low CD4+ T-cell count, detectable viral load, dyslipidemia, hypertension, diabetes, syphilis, prior CVD, and elevated red cell distribution width.
  • Higher CD4+ counts and Hispanic ethnicity were associated with reduced risk, while specific factors like smoking, ART, and dyslipidemia were linked to myocardial infarction; prior CVD and low CD4+ to arrhythmias; and male sex, dyslipidemia, hypertension, and syphilis to stroke.

Conclusions:

  • PLWH experience a considerable burden of cardiovascular events, influenced by both conventional and HIV-specific risk factors.
  • Implementing early cardiovascular risk assessment is essential for this population.
  • Strategies focusing on viral suppression and immunological recovery are critical for mitigating cardiovascular risk in PLWH.
Abstract

Keywords:
HIVcardiovascular eventmeta-analysisprevalencerisk

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