Associations between HIV viremia during antiretroviral therapy and cardiovascular disease.
AIDS
; 36(13): 1829-1834, 2022 11 01.
Article
em En
| MEDLINE
| ID: mdl-35730359
ABSTRACT
OBJECTIVE:
To investigate the association between HIV viremia exposure during antiretroviral therapy (ART) and cardiovascular disease (CVD) risk.DESIGN:
Nationwide observational cohort.METHODS:
Participants (age >15âyears) from the Swedish nationwide InfCareHIV register initiating ART 1996-2017 were categorized in a time-updated manner into four viremia categories, starting from 12âmonths after ART initiation suppression (<50âcopies/ml), low-level viremia (50-199âcopies/ml and 200-999âcopies/ml, respectively), and high-level viremia (≥1000âcopies/ml). In addition, cumulative viremia was estimated as the area under the log viral load (VL) curve. Proportional subhazard models adjusted for sex, age, pre-ART CD4 and VL, injection drug use, and country of birth were used to analyze the association between viremia exposure and CVD risk (ischemic heart disease, stroke, and heart failure; data obtained by linkage to national registers), accounting for the competing risk of non-CVD death.RESULTS:
In all, 337 cases of CVD were observed during 44 937 person-years of follow-up ( n â=â6562). Higher viremia exposure was associated with CVD, both when parameterized as cumulative viremia (adjusted subhazard ratio [aSHR] per 1 log 10 âcopyâ×âyear/ml, 1.03; 95% confidence interval [CI], 1.01-1.05) and as viremia category (aSHR for high-level viremia versus suppression, 1.45; 95% CI, 1.03-2.05). We observed no association between CVD and low-level viremia compared with those with suppression.CONCLUSIONS:
Higher exposure to HIV viremia was linked to CVD in ART recipients, whereas no increased risk was detected for people with low-level viremia compared with viral suppression. Causal inference is limited by the observational nature of this study.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Infecções por HIV
/
Fármacos Anti-HIV
Tipo de estudo:
Risk_factors_studies
Limite:
Adolescent
/
Humans
Idioma:
En
Revista:
AIDS
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2022
Tipo de documento:
Article