Department of Infectious Diseases, Odense University Hospital, Denmark.
BMC Infect Dis. 2010 Jun 14;10:169. doi: 10.1186/1471-2334-10-169.
Previous studies have indicated an increased risk of myocardial infarction (MI) in HIV infected individuals especially after start of highly active antiretroviral therapy (HAART). It is however controversial whether the increased risk of atherosclerotic disease is exclusively associated with the HIV disease and HAART or whether life-style related or genetic factors also increase the risk in this population. To establish whether the increased risk of myocardial infarction in HIV patients partly reflects an increased risk of MI in their families, we estimated the relative risk of MI in parents of HIV-infected individuals.
From the Danish HIV Cohort Study and the Danish Civil Registration System we identified the parents of all HIV-infected patients born in Denmark after 1952 in whom a Danish born mother was identifiable. For each HIV patient, 4 matched population controls and their parents were identified. Cumulative incidence functions were constructed to illustrate time to first MI of the parents as registered in the Danish National Hospital Registry. Incidence rate ratios (IRR) were estimated by Cox's regression analyses. Due to the confidential type of the analysed data the study was approved by the Danish Data Protection Agency.
2,269 mothers and 2,022 fathers of HIV patients as well as 9,076 mothers and 8,460 fathers of control subjects were identified. We observed an increased risk of MI in mothers of HIV patients (adjusted IRR, 1.31; 95% CI: 1.08-1.60). The strongest association was seen in case the offspring was infected heterosexually (adjusted IRR, 1.59; 95% CI: 1.07-2.35) or by IV drug abuse (IVD) (adjusted IRR, 1.63; 95% CI: 1.02-2.60). In fathers of HIV patients the risk of MI was only increased if the offspring was infected by IVD (adjusted IRR, 1.42; 95% CI: 1.01-2.00).
Mothers of HIV-infected patients have an increased risk of MI. We presume that this stems from family related life style risk factors, some of which may also influence the risk of MI in HIV-infected patients.
先前的研究表明，HIV 感染者，尤其是在开始高效抗逆转录病毒治疗（HAART）后，心肌梗死（MI）的风险增加。然而，关于动脉粥样硬化疾病的风险增加是否仅与 HIV 疾病和 HAART 相关，还是与生活方式相关或遗传因素也会增加该人群的风险，这仍存在争议。为了确定 HIV 患者心肌梗死风险的增加是否部分反映了其家族 MI 风险的增加，我们估计了 HIV 感染者父母的 MI 相对风险。
我们从丹麦 HIV 队列研究和丹麦民事登记系统中确定了所有 1952 年后在丹麦出生且母亲是丹麦籍的 HIV 感染者的父母。为每位 HIV 患者确定了 4 名匹配的人群对照及其父母。构建了累积发病率函数来说明父母在丹麦国家医院登记的首次 MI 时间。通过 Cox 回归分析估计发病率比值比（IRR）。由于所分析数据的机密类型，该研究获得了丹麦数据保护局的批准。
确定了 2269 名 HIV 患者的母亲和 2022 名 HIV 患者的父亲，以及 9076 名对照的母亲和 8460 名对照的父亲。我们观察到 HIV 患者的母亲 MI 风险增加（调整后的 IRR，1.31；95%CI：1.08-1.60）。在子女异性传播感染（调整后的 IRR，1.59；95%CI：1.07-2.35）或静脉药物滥用（IVD）感染（调整后的 IRR，1.63；95%CI：1.02-2.60）的情况下，相关性最强。HIV 患者的父亲只有在子女通过 IVD 感染时 MI 风险才增加（调整后的 IRR，1.42；95%CI：1.01-2.00）。
HIV 感染者的母亲 MI 风险增加。我们推测这源于家族相关的生活方式危险因素，其中一些因素也可能影响 HIV 感染者的 MI 风险。
