Changes in atherosclerotic cardiovascular disease risk over time among people living with HIV
Author:
Chen Weisi1, Petoumenos Kathy1, Somia Agus2, Edmiston Natalie3, Chaiwarith Romanee4, Woolley Ian5ORCID, Ross Jeremy6, Pujari Sanjay7, Boettiger David C1ORCID, , Khol V, Ouk V, Pov C, Penh Phnom, Zhang F J, Zhao H X, Han N, Lee M P, Li P C K, Kwong T S, Li T H, Kumarasamy N, Ezhilarasi C, Pujari S, Joshi K, Gaikwad S, Chitalikar A, Borse R T, Mave V, Marbaniang I, Nimkar S, Somia I K A, Merati T P, Sawitri A A S, Yuliana F, Yunihastuti E, Widhani A, Maria S, Karjadi T H, Tanuma J, Oka S, Nishijima T, Choi J Y, S N a, Kim J M, Gani Y M, Rudi N B, Azwa I, Kamarulzaman A, Omar S F Syed, Ponnampalavanar S, Ditangco R, Pasayan M K, Mationg M L, Chen H P, Chan Y J, Wu P F, Ke E, Ng O T, Lim P L, Lee L S, Yap T, Avihingsanon A, Gatechompol S, Phanuphak P, Phadungphon C, Kiertiburanakul S, Phuphuakrat A, Chumla L, Sanmeema N, Chaiwarith R, Sirisanthana T, Praparattanapan J, Nuket K, Khuwuwan S, Kambua P, Pongrapass S, Limlertchareonwanit J, Pham T N, Nguyen K V, Nguyen D T H, Nguyen D T, Do C D, Ngo A V, Nguyen L T, Sohn A H, Ross J L, Petersen B, Law M G, Jiamsakul A, Rupasinghe D, Ellis D, Bloch M, Allen D, Burton L, Baker D, Mousavi R, Farlow H, Byrne E, Templeton D J, Garton L, Doyle T, Jackson Eva, Ryder N, Sweeney G, Moran B, Carr A, Hesse K, Hawkes A, Finlayson R, Shields M, Burdon R, Calleia P, Brown K, Varma R, Bopage R, Walsh J, Varghese S, Chung C, Smith D E, Cogle A, Lawrence C, Mulhall B, Law M, Petoumenos K, Hutchinson J, Rose N, Dougherty T, Byonanebye D, Han A, Rupasinghe D, Russell D, Rodriguez M, Sowden D, Taing K, Broom J, Dennien S, Orth D, Youds D, Priscott E, Benn S, Griggs E, Roth N J, Lau H, Teague R, Silvers J, Zeng W, Levey A, Hoy J, Giles M, Bryant M, Price S, Harris P Rawson, Woolley I, Korman T, O’Bryan J, Cisera K, Raymond N
Affiliation:
1. Kirby Institute, UNSW Sydney , Sydney , Australia 2. Department of Tropical and Infectious Diseases, Udayana University , Denpasar , Indonesia 3. School of Medicine, Rural Research, Western Sydney University , Sydney , Australia 4. Department of Internal Medicine, Faculty of Medicine, Chiang Mai University , Chiang Mai , Thailand 5. Monash Infectious Diseases, Monash Health and Monash University , Melbourne , Australia 6. TREAT Asia, amfAR—The Foundation for AIDS Research , Bangkok , Thailand 7. Institute of Infectious Diseases , Pune , India
Abstract
Abstract
Objective
To describe changes in atherosclerotic cardiovascular disease (ASCVD) risk over time among people living with HIV (PLHIV).
Methods
We used data from the TREAT Asia HIV Observational Database (TAHOD) and the Australian HIV Observational Database (AHOD). Five-year ASCVD risk was calculated using the D:A:D equation. Individuals were eligible for inclusion if they were aged ≥18 years, had started ART, had no previous history of ASCVD and had complete ASCVD risk factor data available within the first 5 years of ART initiation.
Results
A total of 3368 adults contributed data, 3221 were from TAHOD and 147 were from AHOD. The median age at ART initiation was 36 [IQR 31–43] years for TAHOD participants, and 42 [IQR 35–50] years for AHOD participants. Most TAHOD (70.4%) and AHOD (91.8%) participants were male. Overall, ASCVD risk increased from 0.84% (95% CI 0.81%–0.87%) at ART initiation to 1.34% (95% CI 1.29%–1.39%) after 5 years on ART. After adjusting for traditional and HIV-associated ASCVD risk factors, ASCVD risk increased at a similar rate among sub-populations defined by HIV exposure (heterosexuals, men who have sex with men, people who inject drugs), race/ethnicity (Caucasian and Asian) and nadir CD4 at ART initiation (<200 and ≥200 cells/mm3).
Conclusions
These findings emphasize the growing burden of ASCVD risk among PLHIV and the need to develop interventions that are effective across a broad range of HIV sub-populations.
Funder
National Institute of Allergy and Infectious Diseases Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institute of Diabetes and Digestive and Kidney Diseases Australian Government Department of Health and Ageing UNSW Sydney
Publisher
Oxford University Press (OUP)
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