Longitudinal Progression of Subclinical Coronary Atherosclerosis in Swiss HIV-Positive Compared With HIV-Negative Persons Undergoing Coronary Calcium Score Scan and CT Angiography
Author:
Tarr Philip E1, Ledergerber Bruno2, Calmy Alexandra3, Doco-Lecompte Thanh3, Schoepf Isabella C1, Marzel Alex2, Weber Rainer2, Kaufmann Philipp A4, Nkoulou René5, Buechel Ronny R4, Kovari Helen2, Anagnostopoulos A, Battegay M, Bernasconi E, Böni J, Braun D L, Bucher H C, Calmy A, Cavassini M, Ciuffi A, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux C A, Günthard H F, Haerry D, Hasse B, Hirsch H H, Hoffmann M, Hösli I, Huber M, Kahlert C R, Kaiser L, Keiser O, Klimkait T, Kouyos R D, Kovari H, Ledergerber B, Martinetti G, Martinez de Tejada B, Marzolini C, Metzner K J, Müller N, Nicca D, Paioni P, Pantaleo G, Perreau M, Rauch A, Rudin C, Scherrer A U, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Vernazza P, Wandeler G, Weber R, Yerly S, Anagnostopoulos A, Battegay M, Bernasconi E, Böni J, Braun D L, Bucher H C, Calmy A, Cavassini M, Ciuffi A, Dollenmaier G, Egger M, Elzi L, Fehr J, Fellay J, Furrer H, Fux C A, Günthard H F, Haerry D, Hasse B, Hirsch H H, Hoffmann M, Hösli I, Huber M, Kahlert C R, Kaiser L, Keiser O, Klimkait T, Kouyos R D, Kovari H, Ledergerber B, Martinetti G, Martinez de Tejada B, Marzolini C, Metzner K J, Müller N, Nicca D, Paioni P, Pantaleo G, Perreau M, Rauch A, Rudin C, Scherrer A U, Schmid P, Speck R, Stöckle M, Tarr P, Trkola A, Vernazza P, Wandeler G, Weber R, Yerly S,
Affiliation:
1. University Department of Medicine and Division of Infectious Diseases, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland 2. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland 3. Division of Infectious Diseases, University Hospital Geneva, University of Geneva, Geneva, Switzerland 4. Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, University of Zurich, Zurich, Switzerland 5. Division of Cardiology, University Hospital Geneva, University of Geneva, Geneva, Switzerland
Abstract
AbstractBackgroundPeople with HIV (HIV+) may have increased cardiovascular event rates compared with HIV-negative (HIV-) persons. Cross-sectional data from the United States and Switzerland, based on coronary artery calcium scan (CAC) and coronary computed tomography angiography (CCTA), suggest, respectively, increased and similar prevalence of subclinical atherosclerosis in HIV+ vs HIV- persons.MethodsWe repeated CAC/CCTA in 340 HIV+ and 90 HIV- study participants >2 years after baseline CAC/CCTA. We assessed the association of HIV infection, Framingham risk score (FRS), and HIV-related factors with the progression of subclinical atherosclerosis.ResultsHIV+ were younger than HIV- participants (median age, 52 vs 56 years; P < .01) but had similar median 10-year FRS (8.9% vs 9.0%; P = .82); 94% had suppressed HIV viral load. In univariable and multivariable analyses, FRS was associated with the incidence rate ratio (IRR) of new subclinical atherosclerosis at the follow-up CAC/CCTA, but HIV infection was not: any plaque (adjusted IRR for HIV+ vs HIV- participants, 1.21; 95% CI, 0.62–2.35), calcified plaque (adjusted IRR for HIV+ vs HIV- participants, 1.06; 95% CI, 0.56–2), noncalcified/mixed plaque (adjusted IRR for HIV+ vs HIV- participants, 1.24; 95% CI, 0.69–2.21), and high-risk plaque (adjusted IRR for HIV+ vs HIV- participants, 1.46; 95% CI, 0.66–3.20). Progression of CAC score between baseline and follow-up CAC/CCTA was similar in HIV+ (median annualized change [interquartile range {IQR}], 0.41 [0–10.19]) and HIV- participants (median annualized change [IQR], 2.38 [0–16.29]; P = .11), as was progression of coronary segment severity score (HIV+: median annualized change [IQR], 0 [0–0.47]; HIV-: median annualized change [IQR], 0 [0–0.52]; P = .10) and coronary segment involvement score (HIV+: median annualized change [IQR], 0 [0–0.45]; HIV-: median annualized change [IQR], 0 [0–0.41]; P = .25).ConclusionsIn this longitudinal CAC/CCTA study from Switzerland, Framingham risk score was associated with progression of subclinical atherosclerosis, but HIV infection was not.
Funder
Swiss National Science Foundation
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
Cited by
6 articles.
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