HIV infection associated with 68% increased risk for HF
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Individuals with HIV were at elevated risk for developing HF compared with individuals without HIV, according to new research published in Mayo Clinic Proceedings.
The retrospective cohort study included 38,868 individuals with HIV (mean age, 41 years; 12% women) frequency-matched based on age, sex, race, primary treating facility and first year of follow-up with 386,586 individuals without HIV (mean age, 41 years; 12% women) from 2000 to 2016. Researchers evaluated incident HF risk and the association with HIV infection overall and by left ventricular systolic function and whether HF risk varied by demographics.
The rate of incident HF was 0.23 per 100 person-years among individuals with HIV compared with 0.15 per 100 person-years among individuals without HIV following a median follow-up of 3.8 years (P < .001). There was a higher adjusted rate for incident HF of 68% among individuals with HIV (adjusted HR = 1.68; 95% CI, 1.52-1.85), which remained after further adjustment for CV medication use (aHR = 1.73; 95% CI, 1.57-1.91). Further adjustment for ACS hospitalizations modestly attenuated the results (aHR = 1.63; 95% CI, 1.47-1.81).
Among individuals with HIV, the adjusted incident HF risk was most prominent among those aged 40 years and younger (aHR = 2.45; 95% CI, 1.92-3.03), women (aHR = 2.48; 95% CI, 1.9-3.26) and Asian/Pacific Islander individuals (aHR = 2.46; 95% CI, 1.27-4.74).
“In terms of young people, it’s possible that they had fewer other complicating health issues, which made heart failure stand out,” Alan S. Go, MD, senior research scientist in the division of research at Kaiser Permanente Northern California, Oakland, said in a press release. “In women, preliminary data suggest HIV may have a greater impact on their cardiac function than it does in men, due in part to hormonal regulation and enhanced myocardial fibrosis, but that needs to be investigated further. And, overall, not a lot is known about cardiac issues and HIV among Asians and Pacific Islanders.”
The results did not vary by systolic function category.
“Our study showed that the higher risk wasn’t due to differences in access to care. They were all getting the highest-quality care,” Go said in the release. “The study also showed that the higher heart failure risk was not because people with HIV had more risk factors for heart disease or just experienced more heart attacks. In fact, there was a higher prevalence of risk factors for cardiovascular disease among those without HIV.”
Reference:
- People with HIV are at increased risk for heart failure. Published Dec. 13, 2021. Accessed Dec. 15, 2021.
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