Incidence of Cardiometabolic Diseases in People With and Without Human Immunodeficiency Virus in the United Kingdom: A Population-Based Matched Cohort Study

• Published in: The Journal of infectious diseases 2022-04, Vol.225 (8), p.1348-1356
• Main Authors: Gooden, Tiffany E, Gardner, Mike, Wang, Jingya, Jolly, Kate, Lane, Deirdre A, Benjamin, Laura A, Mwandumba, Henry C, Kandoole, Vanessa, Lwanga, Isaac B, Taylor, Stephen, Manaseki-Holland, Semira, Lip, Gregory Y H, Nirantharakumar, Krishnarajah, Thomas, G Neil
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - etiology; Cerebral infarction; Cohort analysis; Cohort Studies; Comorbidity; Congestive heart failure; Coronary artery disease; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Female; HIV; HIV Infections - complications; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Hypertension; Hypertension - complications; Hypertension - epidemiology; Immune system; Incidence; Ischemia; Kidney diseases; Major and Brief Reports; Male; Mortality; Myocardial infarction; Myocardial Infarction - complications; Population studies; Population-based studies; Regression analysis; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - epidemiology; Risk Factors; Stroke - complications; United Kingdom - epidemiology; Vascular diseases; Viruses
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jiab420

Abstract Background Evidence on the risk of cardiovascular disease (CVD) and CVD risk factors in people with human immunodeficiency virus (PWH) is limited. We aimed to identify the risk of composite CVD, individual CVD events, and common risk factors. Methods This was a nationwide, population-based, cohort study comparing adult (≥18 years old) PWH with people without human immunodeficiency virus (HIV) matched on age, sex, ethnicity, and location. The primary outcome was composite CVD comprising stroke, myocardial infarction, peripheral vascular disease, ischemic heart disease, and heart failure. The secondary outcomes were individual CVD events, hypertension, diabetes, chronic kidney disease (CKD), and all-cause mortality. Cox proportional hazard regression models were used to examine the risk of each outcome. Results We identified 9233 PWH and matched them with 35 721 HIV-negative individuals. An increased risk was found for composite CVD (adjusted hazard ratio [aHR], 1.50; 95% confidence interval [CI], 1.28–1.77), stroke (aHR, 1.42; 95% CI, 1.08–1.86), ischemic heart disease (aHR, 1.55; 95% CI, 1.24–1.94), hypertension (aHR, 1.37; 95% CI, 1.23–1.53), type 2 diabetes (aHR, 1.28; 95% CI, 1.09–1.50), CKD (aHR, 2.42; 95% CI, 1.98–2.94), and all-cause mortality (aHR, 2.84; 95% CI, 2.48–3.25). Conclusions PWH have a heightened risk for CVD and common CVD risk factors, reinforcing the importance for regular screening for such conditions. Comparing people with HIV (PWH) to matched people without HIV over a 20-year follow up, we report an increased risk for composite cardiovascular disease, stroke, ischemic heart disease, hypertension, type 2 diabetes, chronic kidney disease, and all-cause mortality for PWH.