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Atherosclerotic Cardiovascular Events in Patients Infected With Human Immunodeficiency Virus and Hepatitis C Virus

2020; Oxford University Press; Volume: 72; Issue: 9 Linguagem: Inglês

10.1093/cid/ciaa1014

1537-6591

Boun Kim Tan, Mathieu Chalouni, Dominique Salmon Ceron, A. Cinaud, Laure Esterle, Marc Arthur Loko, Christine Katlama, Isabelle Poizot‐Martin, D. Neau, J. Chas, Philippe Morlat, Eric Rosenthal, Karine Lacombe, Alissa Naqvi, Karl Barange, Olivier Bouchaud, Anne Gervais, Caroline Lascoux‐Combe, D. Garipuy, Laurent Alric, Cécile Goujard, Patrick Miailhes, Hugues Aumaître, Claudine Duvivier, Anne Simon, José-Luis López-Zaragoza, David Zucman, François Raffi, Estibaliz Lazaro, David Rey, Lionel Piroth, François Boué, Camille Gilbert, Firouzé Bani‐Sadr, François Dabis, P. Sogni, Linda Wittkop, Franck Boccara,

Systemic Lupus Erythematosus Research

An increased risk of cardiovascular disease (CVD) was reported in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), without identifying factors associated with atherosclerotic CVD (ASCVD) events.HIV-HCV coinfected patients were enrolled in the Agence Nationale de Recherches sur le Sida et les hépatites virales (ANRS) CO13 HEPAVIH nationwide cohort. Primary outcome was total ASCVD events. Secondary outcomes were coronary and/or cerebral ASCVD events, and peripheral artery disease (PAD) ASCVD events. Incidences were estimated using the Aalen-Johansen method. Factors associated with ASCVD were identified using cause-specific Cox proportional hazards models.At baseline, median age of the study population (N = 1213) was 45.4 (interquartile range [IQR] 42.1-49.0) years and 70.3% were men. After a median follow-up of 5.1 (IQR 3.9-7.0) years, the incidence was 6.98 (95% confidence interval [CI], 5.19-9.38) per 1000 person-years for total ASCVD events, 4.01 (2.78-6.00) for coronary and/or cerebral events, and 3.17 (2.05-4.92) for PAD ASCVD events. Aging (hazard ratio [HR] 1.06; 95% CI, 1.01-1.12), prior CVD (HR 8.48; 95% CI, 3.14-22.91), high total cholesterol (HR 1.43; 95% CI, 1.11-1.83), high-density lipoprotein cholesterol (HR 0.22; 95% CI, 0.08-0.63), statin use (HR 3.31; 95% CI, 1.31-8.38), and high alcohol intake (HR 3.18; 95% CI, 1.35-7.52) were independently associated with total ASCVD events, whereas undetectable baseline viral load (HR 0.41, 95% CI, 0.18-0.96) was associated with coronary and/or cerebral events.HIV-HCV coinfected patients experienced a high incidence of ASCVD events. Some traditional cardiovascular risk factors were the main determinants of ASCVD. Controlling cholesterol abnormalities and maintaining undetectable HIV RNA are essential to control cardiovascular risk.