HF risk higher, treatment rates lower among patients with HIV

NATIONAL HARBOR, Md. — Patients with HIV are at increased risk for HF compared with noninfected patients, but optimal treatment for HF is significantly less common among those with HIV, researchers reported at the Heart Failure Society of America Annual Scientific Meeting.

“Despite improvements in HIV treatment, [these] patients are still at high risk for CVD,” Sadeer G. Al-Kindi, MD, University Hospitals Case Medical Center in Cleveland, said during a presentation. “We sought to estimate the prevalence of HF in HIV patients because this has not been explored before.”

The researchers identified 26,330 patients with HIV and 12,148,450 controls without HIV treated at hospitals between March 2014 and March 2015, using data collected from Explorys, an electronic database incorporating records from 23 health care systems throughout the United States, representing more than 15 million patients. All included patients and controls were aged 18 to 64 years.

Patients with HIV had HF in 8% of cases vs. 4.3% of controls (RR = 1.85; 95% CI, 1.78-1.93). Al-Kindi said HF prevalence increased with age among patients with HIV, and women were at increased risk for HF across all age groups, but the RR for HF was greatest for both sexes among patients aged 30 to 34 years (RR = 12.7 for women vs. 7.1 for men). Risk for HF was slightly lower among patients receiving antiretroviral therapy (7.1% vs. 8.6% among untreated patients; P < .0001).

Fewer than half of patients with HIV and HF were receiving treatment with diuretics, Al-Kindi said. Use of diuretics, antiplatelet medications and diuretics were all less common among patients with HIV and HF compared with patients with HF alone (P < .0001 for all). Rates of treatment with beta-blockers, ACE inhibitors and angiotensin receptor blockers were similar between infected and noninfected patients. Al-Kindi said referral to a cardiologist was associated with a doubling of the rate of guideline-directed medical therapy.

“Patients with HIV are at higher risk for HF than the general population,” Al-Kindi concluded, “[but] HIV-infected patients with HF are undertreated compared with controls with HF, especially those who take diuretics.” – by Adam Taliercio

Reference:

Al-Kindi S, et al. Rapid-Fire Abstracts II. Presented at: Heart Failure Society of America Annual Scientific Meeting; Sept. 26-29, 2015; National Harbor, Md.

Disclosure: Al-Kindi reports no relevant financial disclosures.