Department of Infectious Diseases, Monash University, Melbourne, Vic., Australia.
Department of Infectious Diseases, Austin Health, Melbourne, Vic., Australia; and Department of Infectious Diseases at the Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Vic., Australia.
Sex Health. 2023 Oct;20(5):470-474. doi: 10.1071/SH23043.
People living with HIV (PLHIV) are at increased risk for coronary artery disease (CAD). This study aimed to describe the features associated with CAD in PLHIV.
A case ([n =160] PLHIV with CAD) control ([n =317] PLHIV matched by age and sex without CAD) study was performed at the Alfred Hospital, Melbourne, Australia (January 1996 and December 2018). Data collected included CAD risk factors, duration of HIV infection, nadir and at-event CD4+ T-cell counts, CD4:CD8 ratio, HIV viral load, and antiretroviral therapy exposure.
Participants were predominantly male (n =465 [97.4%]), with a mean age of 53years. Traditional risk factors associated with CAD in univariate analysis included hypertension (OR 11.4 [95%CI 5.01, 26.33], P <0.001), current cigarette smoking (OR 2.5 [95% CI 1.22, 5.09], P =0.012), and lower high-density lipoprotein cholesterol (OR 0.14 [95%CI 0.05, 0.37], P <0.001). There was no association between duration of HIV infection, nadir or current CD4 cell count. However, current and ever exposure to abacavir (cases: 55 [34.4%]; controls: 79 [24.9%], P =0.023 and cases: 92 [57.5%]; controls: 154 [48.6%], P =0.048, respectively) was associated with CAD. In conditional logistic regression analysis, current abacavir use, current smoking, and hypertension remained significantly associated (aOR=1.87 [CI=1.14, 3.07], aOR=2.31 [1.32, 4.04], and aOR=10.30 [5.25, 20.20] respectively).
Traditional cardiovascular risk factors and exposure to abacavir were associated with CAD in PLHIV. This study highlights that aggressive management of cardiovascular risk factors remains critical for reducing risk in PLHIV.
艾滋病毒感染者（PLHIV）患冠状动脉疾病（CAD）的风险增加。本研究旨在描述与 PLHIV 中 CAD 相关的特征。
在澳大利亚墨尔本阿尔弗雷德医院进行了一项病例对照研究（病例组 [n=160] 为 PLHIV 合并 CAD，对照组 [n=317] 为年龄和性别匹配且无 CAD 的 PLHIV）。收集的数据包括 CAD 危险因素、HIV 感染持续时间、最低和发病时 CD4+T 细胞计数、CD4:CD8 比值、HIV 病毒载量和抗逆转录病毒治疗暴露情况。
参与者主要为男性（n=465 [97.4%]），平均年龄为 53 岁。单因素分析中与 CAD 相关的传统危险因素包括高血压（OR 11.4 [95%CI 5.01, 26.33]，P<0.001）、当前吸烟（OR 2.5 [95%CI 1.22, 5.09]，P=0.012）和低高密度脂蛋白胆固醇（OR 0.14 [95%CI 0.05, 0.37]，P<0.001）。HIV 感染持续时间、最低和当前 CD4 细胞计数与 CAD 之间无关联。然而，当前和既往使用阿巴卡韦（病例组：55 [34.4%]；对照组：79 [24.9%]，P=0.023 和病例组：92 [57.5%]；对照组：154 [48.6%]，P=0.048）与 CAD 相关。在条件逻辑回归分析中，当前阿巴卡韦使用、当前吸烟和高血压仍然与 CAD 显著相关（调整后的 OR=1.87 [95%CI 1.14, 3.07]、调整后的 OR=2.31 [95%CI 1.32, 4.04] 和调整后的 OR=10.30 [95%CI 5.25, 20.20]）。
传统心血管危险因素和阿巴卡韦暴露与 PLHIV 中的 CAD 相关。本研究强调，积极管理心血管危险因素对于降低 PLHIV 的风险仍然至关重要。
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