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Risk of Cardiovascular Disease Among People Living With HIV With Immunological Nonresponse

Chenlu Xu1, Guoxiang Zheng2, Liu Li3

  • 1Department of Nosocomial Infection Management, Hangzhou Xixi Hospital, Hangzhou, Zhejiang, China.

Journal of the International Association of Providers of AIDS Care
|August 11, 2026
PubMed

Insights

People living with HIV (PLWH) experiencing poor immune reconstitution face higher risks of cardiovascular disease (CVD) and cardiac abnormalities. Targeted screening is crucial for this vulnerable population, especially older individuals.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Immunology

Background:

  • Cardiovascular disease (CVD) is a significant concern for people living with HIV (PLWH).
  • Immunological non-response (INR) may impact CVD risk and cardiac health in PLWH.
  • Subclinical cardiac abnormalities are increasingly recognized in PLWH.

Purpose of the Study:

  • To compare 10-year CVD risk and echocardiographic abnormalities between PLWH with INR and those with immunological response (IR).
  • To identify factors associated with increased CVD risk and cardiac abnormalities in PLWH.

Main Methods:

  • Cross-sectional study involving 520 PLWH (260 INR, 260 IR matched for age and gender).
  • Echocardiography performed for all participants.
  • Cardiovascular risk assessed using the Framingham Risk Score (FRS).

Main Results:

  • PLWH with INR had significantly higher 10-year CVD risk (11.86% vs 9.51%) and more echocardiographic abnormalities (83.5% vs 74.2%) compared to IR controls.
  • Factors associated with increased CVD risk included longer treatment duration, larger waist circumference, prolonged prothrombin time, lower education, and carotid plaque.
  • Within the INR group, age and lower CD19+ levels correlated with echocardiographic abnormalities. An interaction between age and immune reconstitution status on CVD risk was observed.

Conclusions:

  • Poor immune reconstitution is linked to elevated CVD risk and subclinical cardiac abnormalities in PLWH.
  • Older PLWH with poor immune reconstitution are particularly vulnerable.
  • Findings highlight the need for tailored cardiovascular screening strategies in this population.

Keywords:
Framingham general cardiovascular risk scoreHIVcardiovascular diseaseimmunological nonresponserisk factors

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