Cardiology Section, San Francisco VA Healthcare System and Department of Medicine, University of California San Francisco, San Francisco, CA.
Division of Cardiology, Department of Medicine, State University of New York Health Science Center - Brooklyn, Brooklyn.
AIDS. 2021 Aug 1;35(10):1647-1655. doi: 10.1097/QAD.0000000000002920.
HIV and HCV have each been linked with cardiac dysfunction. Studies of HIV have often lacked appropriate controls and primarily involved men, whereas data for HCV are sparse.
We performed repeat echocardiography over a median interval of 12 years in participants from the Women's Interagency HIV Study in order to evaluate the relationships of HIV and HCV with incident left ventricular (LV) dysfunction (systolic or diastolic).
Of the 311 women included (age 39 ± 9), 70% were HIV-positive and 20% HCV-positive. Forty three participants (13.8%) developed LV dysfunction, of which 79.1% was diastolic. Compared with participants with neither infection, the group with HIV--HCV coinfection showed a significantly increased risk of incident LV dysfunction after adjustment for risk factors [RR = 2.96 (95% CI = 1.05-8.31)], but associations for the HCV monoinfected and HIV monoinfected groups were not statistically significant [RR = 2.54 (0.83-7.73) and RR = 1.66 (0.65-4.25), respectively]. Comparison of HCV-positive and HCV-negative women showed a significantly increased risk independent of covariates [RR = 1.96 (1.02-3.77)] but this was not the case for HIV-positive vs. HIV-negative women [RR = 1.43 (0.76-2.69)]. There was no evidence of HCV-by-HIV interaction. A more restrictive definition of LV diastolic dysfunction led to fewer incident cases, but a similar, though nonsignificant, risk estimate for HCV.
Among mostly middle-aged women, HCV but not HIV infection was associated with a pronounced risk of incident LV dysfunction. Although the influence of residual confounding cannot be excluded, these findings bolster the potential benefits that could be realized by adopting recent recommendations for expanding HCV screening and treatment.
HIV 和 HCV 均与心功能障碍有关。HIV 的研究往往缺乏适当的对照，且主要涉及男性，而 HCV 的数据则很少。
我们对妇女艾滋病病毒研究机构间小组的参与者进行了中位数为 12 年的重复超声心动图检查，以评估 HIV 和 HCV 与新发左心室（LV）功能障碍（收缩或舒张）的关系。
在纳入的 311 名女性（年龄 39±9 岁）中，70%为 HIV 阳性，20%为 HCV 阳性。43 名参与者（13.8%）出现 LV 功能障碍，其中 79.1%为舒张功能障碍。与未感染的参与者相比，HIV-HCV 合并感染组在调整了危险因素后，新发 LV 功能障碍的风险显著增加[RR=2.96（95%CI=1.05-8.31）]，而 HCV 单一感染和 HIV 单一感染组的相关性则无统计学意义[RR=2.54（0.83-7.73）和 RR=1.66（0.65-4.25）]。HCV 阳性和 HCV 阴性女性之间的比较显示，在排除了混杂因素后，风险显著增加[RR=1.96（1.02-3.77）]，但 HIV 阳性与 HIV 阴性女性之间的情况并非如此[RR=1.43（0.76-2.69）]。未发现 HCV 与 HIV 之间存在交互作用。LV 舒张功能障碍的更严格定义导致新发病例较少，但 HCV 的风险估计值虽然相似，但无统计学意义。
在大多数中年女性中，HCV 感染而不是 HIV 感染与新发 LV 功能障碍的显著风险相关。尽管不能排除残余混杂因素的影响，但这些发现支持了最近扩大 HCV 筛查和治疗建议所带来的潜在益处。
