HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death

Background People living with HIV have higher sudden cardiac death (SCD) rates compared with the general population. Whether HIV infection is an independent SCD risk factor is unclear. Methods and Results This study evaluated participants from the Veterans Aging Cohort Study, an observational, longi...

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Auteurs principaux:	Matthew S. Freiberg, Meredith S. Duncan, Charles Alcorn, Chung‐Chou H. Chang, Suman Kundu, Asri Mumpuni, Emily K. Smith, Sarah Loch, Annie Bedigian, Eric Vittinghoff, Kaku So‐Armah, Priscilla Y. Hsue, Amy C. Justice, Zian H. Tseng
Format:	article
Langue:	EN
Publié:	Wiley 2021
Sujets:	CD4 cell count HIV infection HIV viral load sudden cardiac death Diseases of the circulatory (Cardiovascular) system RC666-701
Accès en ligne:	https://doaj.org/article/03ed5716a1694e13be8917816733d94e
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spelling	oai:doaj.org-article:03ed5716a1694e13be8917816733d94e2021-11-23T11:36:35ZHIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death10.1161/JAHA.121.0212682047-9980https://doaj.org/article/03ed5716a1694e13be8917816733d94e2021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.021268https://doaj.org/toc/2047-9980Background People living with HIV have higher sudden cardiac death (SCD) rates compared with the general population. Whether HIV infection is an independent SCD risk factor is unclear. Methods and Results This study evaluated participants from the Veterans Aging Cohort Study, an observational, longitudinal cohort of veterans with and without HIV infection matched 1:2 on age, sex, race/ethnicity, and clinical site. Baseline for this study was a participant's first clinical visit on or after April 1, 2003. Participants were followed through December 31, 2014. Using Cox proportional hazards regression, we assessed whether HIV infection, CD4 cell counts, and/or HIV viral load were associated with World Health Organization (WHO)–defined SCD risk. Among 144 336 participants (30% people living with HIV), the mean (SD) baseline age was 50.0 years (10.6 years), 97% were men, and 47% were of Black race. During follow‐up (median, 9.0 years), 3035 SCDs occurred. HIV infection was associated with increased SCD risk (hazard ratio [HR], 1.14; 95% CI, 1.04–1.25), adjusting for possible confounders. In analyses with time‐varying CD4 and HIV viral load, people living with HIV with CD4 counts <200 cells/mm3 (HR, 1.57; 95% CI, 1.28–1.92) or viral load >500 copies/mL (HR, 1.70; 95% CI, 1.46–1.98) had increased SCD risk versus veterans without HIV. In contrast, people living with HIV who had CD4 cell counts >500 cells/mm3 (HR, 1.03; 95% CI, 0.90–1.18) or HIV viral load <500 copies/mL (HR, 0.97; 95% CI, 0.87–1.09) were not at increased SCD risk. Conclusions HIV infection is associated with increased risk of WHO‐defined SCD among those with elevated HIV viral load or low CD4 cell counts.Matthew S. FreibergMeredith S. DuncanCharles AlcornChung‐Chou H. ChangSuman KunduAsri MumpuniEmily K. SmithSarah LochAnnie BedigianEric VittinghoffKaku So‐ArmahPriscilla Y. HsueAmy C. JusticeZian H. TsengWileyarticleCD4 cell countHIV infectionHIV viral loadsudden cardiac deathDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	CD4 cell count HIV infection HIV viral load sudden cardiac death Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	CD4 cell count HIV infection HIV viral load sudden cardiac death Diseases of the circulatory (Cardiovascular) system RC666-701 Matthew S. Freiberg Meredith S. Duncan Charles Alcorn Chung‐Chou H. Chang Suman Kundu Asri Mumpuni Emily K. Smith Sarah Loch Annie Bedigian Eric Vittinghoff Kaku So‐Armah Priscilla Y. Hsue Amy C. Justice Zian H. Tseng HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death
description	Background People living with HIV have higher sudden cardiac death (SCD) rates compared with the general population. Whether HIV infection is an independent SCD risk factor is unclear. Methods and Results This study evaluated participants from the Veterans Aging Cohort Study, an observational, longitudinal cohort of veterans with and without HIV infection matched 1:2 on age, sex, race/ethnicity, and clinical site. Baseline for this study was a participant's first clinical visit on or after April 1, 2003. Participants were followed through December 31, 2014. Using Cox proportional hazards regression, we assessed whether HIV infection, CD4 cell counts, and/or HIV viral load were associated with World Health Organization (WHO)–defined SCD risk. Among 144 336 participants (30% people living with HIV), the mean (SD) baseline age was 50.0 years (10.6 years), 97% were men, and 47% were of Black race. During follow‐up (median, 9.0 years), 3035 SCDs occurred. HIV infection was associated with increased SCD risk (hazard ratio [HR], 1.14; 95% CI, 1.04–1.25), adjusting for possible confounders. In analyses with time‐varying CD4 and HIV viral load, people living with HIV with CD4 counts <200 cells/mm3 (HR, 1.57; 95% CI, 1.28–1.92) or viral load >500 copies/mL (HR, 1.70; 95% CI, 1.46–1.98) had increased SCD risk versus veterans without HIV. In contrast, people living with HIV who had CD4 cell counts >500 cells/mm3 (HR, 1.03; 95% CI, 0.90–1.18) or HIV viral load <500 copies/mL (HR, 0.97; 95% CI, 0.87–1.09) were not at increased SCD risk. Conclusions HIV infection is associated with increased risk of WHO‐defined SCD among those with elevated HIV viral load or low CD4 cell counts.
format	article
author	Matthew S. Freiberg Meredith S. Duncan Charles Alcorn Chung‐Chou H. Chang Suman Kundu Asri Mumpuni Emily K. Smith Sarah Loch Annie Bedigian Eric Vittinghoff Kaku So‐Armah Priscilla Y. Hsue Amy C. Justice Zian H. Tseng
author_facet	Matthew S. Freiberg Meredith S. Duncan Charles Alcorn Chung‐Chou H. Chang Suman Kundu Asri Mumpuni Emily K. Smith Sarah Loch Annie Bedigian Eric Vittinghoff Kaku So‐Armah Priscilla Y. Hsue Amy C. Justice Zian H. Tseng
author_sort	Matthew S. Freiberg
title	HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death
title_short	HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death
title_full	HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death
title_fullStr	HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death
title_full_unstemmed	HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death
title_sort	hiv infection and the risk of world health organization–defined sudden cardiac death
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/03ed5716a1694e13be8917816733d94e
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HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death

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