Severe infection tied to increased risk for cardiovascular disease in HIV patients

  • Mesquita EC & al.
  • BMC Infect Dis
  • 11 Apr 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This study provides evidence for a time-dependent association between severe infection and incident cardiovascular disease (CVD) in HIV-infected patients.
  • Combined antiretroviral therapy (cART) use and high CD4 count were significantly associated with a lower risk for CVD.

Why this matters

  • Findings suggest that a past medical history of hospitalisation for severe infection should be part of the cardiovascular risk assessment performed by HIV/AIDS caregivers.

Study design

  • 3384 HIV-infected patients (age, ≥18 years) without CVD were followed until the occurrence of the first CVD event, death or end of the study, whichever occurred first, from January 2000 to December 2013.
  • Patient’s post-infection follow-up time was divided into 3 periods: 1 year post-hospitalisation.
  • Funding: Conselho Nacional de Desenvolvimento Científico e Tecnológico and others.

Key results

  • Of 3384 HIV-infected patients, 184 developed incident CVD events during the follow-up (incidence rate, 11.10/1000 person-years [95% CI, 9.60-12.82]).
  • In adjusted analysis, non-white race/ethnicity (adjusted HR [aHR], 1.49; P=.009), age ≥60 years (aHR, 2.01; P=.045) and hypertension (aHR, 1.90; P<.001 were associated with increased risk for cvd.>
  • High CD4 count (≥500 cells/mm3; aHR, 0.41) and cART use (aHR, 0.21; P<.001 for both were significantly associated with reduced risk cvd.>
  • Severe infections were significantly associated with increased risk for CVD at

Limitations

  • Observational design.

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