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CVD mortality rates greater among those with HIV

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SEATTLE — Cardiovascular disease mortality rates were greater for patients aged younger than 65 years with HIV, recent data suggest.

“As time has passed, due to antiretroviral treatment there have been improvements in survival in people with HIV, but at the same time, increases in proportions of deaths due to cardiovascular disease [CVD],” David B. Hanna, PhD, of the Albert Einstein College of Medicine, told Infectious Disease News at CROI 2015. “These findings are demonstrative of what others have seen in smaller research studies, but our study provides an example of this within the entire reported population of a large city with high HIV prevalence.”

Hanna and colleagues examined data reported to the New York City HIV Surveillance Registry and linked to the city’s Vital Statistics Registry and National Death Index between 2001 and 2012. All persons aged 13 years or older with HIV who were reported to the city’s registries were included (n = 145,009). Time trends were identified using log-linear models, which were compared with those of city residents without HIV.

Throughout the study period, there were 29,326 deaths reported among those with HIV. Ten percent were attributed to major CVDs, the most common being chronic ischemic heart disease (42%), hypertensive diseases (27%) and cerebrovascular diseases (10%).

CVD mortality rates among individuals with HIV decreased during the study period from 5.4 per 1,000 person-years (95% CI, 3.5-7.3) to 2.3 per 1,000 person-years (95% CI, 2-2.7), although the proportion of HIV deaths attributed to CVD increased from 6% to 14% (P < .001).

After controlling for sex, race, ethnicity, borough of residence and year, Hanna and colleagues determined that individuals with HIV had a higher CVD mortality rate than uninfected individuals before the age of 65 years.

“While CVD mortality rates decreased over the decade, both viremic and virologically suppressed HIV-infected individuals had higher CVD mortality rates than uninfected individuals until age 65,” the researchers wrote. “HIV care providers should continue to emphasize preventive measures such as smoking cessation, blood pressure control and lipid management to reduce CVD risk.” – by Dave Muoio

Reference:

Hanna DB, et al. Abstract 729. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 23-26, 2015; Seattle.

Disclosure: Hanna reports no relevant financial disclosures.