Risk for myocardial infarction increases among people with HIV
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The risk for myocardial infarction has increased in recent years among people with HIV in the United States, data presented at the Conference on Retroviruses and Opportunistic Infections suggest.
“Cardiovascular disease remains the leading cause of morbidity and mortality in the U.S., and the risk is much higher in HIV patients — 40% to 80% higher, and that's likely due to several factors,” Michael J. Silverberg, PhD, MPH, a research scientist and HIV epidemiologist at Kaiser Permanente Northern California, said during a presentation.
“With an aging cohort of people with HIV and potential adverse effects of newer ART — such as integrase inhibitors and the potential related weight gain — it is critical to continue modern monitoring trends and [myocardial infarction (MI)] rates by HIV status,” Silverberg said.
Participants in the study were chosen from two health care systems — Massachusetts General Hospital (Partners) and Kaiser Permanente Northern California — from 2005 to 2017, with follow-up through 2020.
Silverberg and colleagues assessed the effects of HIV status on MI risk in two calendar eras — the from 2005 to 2009 and 2010 to 2017. The study included 10,312 people living with HIV and 23,018 people without HIV, including 238 who experienced an MI.
Participants had a median age of 43 years, and 87% were men. They had a mean cholesterol of 180 mg/dL, a mean HDL of 44 mg/dL, a mean systolic blood pressure of 123 mmHg, 6% had diabetes, 25% were on treatment for hypertension, and 26% were smokers.
For the years 2005 to 2009, the adjusted HR for MI among people with HIV was 0.99 (95% CI, 0.67-1.45). It increased to 1.85 (95% CI, 1.26-2.72) for the years 2010 to 2017.
“The results appear to be driven by a decrease in the MI risk over time for people without HIV, that was not seen for their counterparts,” Silverberg said. “HIV-specific factors such as longer duration of HIV and use of new ART may have prevented people with HIV from realizing the same improvements in MI risk as people without HIV.”
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Silverberg MJ, et al. Abstract 39. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 12-16, 2022 (virtual meeting).
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