在以黑人为主的感染HIV及相关合并症队列中动脉粥样硬化性心血管疾病风险评分的变化：一项初步研究
Changes in Atherosclerotic Cardiovascular Disease Risk Scores in a Predominantly Black Cohort with HIV and Associated Comorbidities: A Preliminary Study.
作者信息
Burrowes Shana A B, Zisman Erin, Fantry Lori E, Bui Quoc, Wu Angela, Sorkin John, Miller Michael, Bagchi Shashwatee
机构信息
Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA.
Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
出版信息
Cardiology. 2025;150(2):194-202. doi: 10.1159/000540526. Epub 2024 Aug 6.
INTRODUCTION
People with HIV (PWH) have an increased risk of atherosclerotic cardiovascular disease (ASCVD) compared to non-PWH, but the reasons for this increased risk remain elusive. We investigated the change in ASCVD risk scores over 4 years to identify clinical factors associated with change in risk scores or high-risk scores.
METHODS
We conducted a preliminary study using retrospective analysis of PWH, between 40 and 75 years old, seen at the Evelyn Jordan Center with at least two routine HIV visits. We collected clinical and demographic data and calculated the ASCVD risk scores using the Pooled Cohort Equation. Exploratory analyses examined change in risk score categories over time. Final adjusted analysis examined factors associated with change in continuous risk scores over time.
RESULTS
Our sample included 187 PWH; 166 were black/African American and 79 were female. We found no significant change in ASCVD risk score over time. The risk score was significantly higher in PWH with hepatitis C (7.34%; 95% CI: 2.59, 12.09; p = 0.003) and trended higher in those with dual hepatitis B/C and hepatitis B compared to those without hepatitis (p = 0.07).
CONCLUSION
We found that ASCVD risk did not change over a 4-year period among predominantly black young PWH, but infection with hepatitis C and dual hepatitis B/C were associated with higher ASCVD risk scores. Our findings illustrate the need for further longitudinal studies evaluating change in cardiovascular disease (CVD) risk and investigating viral hepatitis as an added potential contributor to increased CVD risk in high-risk, vulnerable populations.
INTRODUCTION
People with HIV (PWH) have an increased risk of atherosclerotic cardiovascular disease (ASCVD) compared to non-PWH, but the reasons for this increased risk remain elusive. We investigated the change in ASCVD risk scores over 4 years to identify clinical factors associated with change in risk scores or high-risk scores.
METHODS
We conducted a preliminary study using retrospective analysis of PWH, between 40 and 75 years old, seen at the Evelyn Jordan Center with at least two routine HIV visits. We collected clinical and demographic data and calculated the ASCVD risk scores using the Pooled Cohort Equation. Exploratory analyses examined change in risk score categories over time. Final adjusted analysis examined factors associated with change in continuous risk scores over time.
RESULTS
Our sample included 187 PWH; 166 were black/African American and 79 were female. We found no significant change in ASCVD risk score over time. The risk score was significantly higher in PWH with hepatitis C (7.34%; 95% CI: 2.59, 12.09; p = 0.003) and trended higher in those with dual hepatitis B/C and hepatitis B compared to those without hepatitis (p = 0.07).
CONCLUSION
We found that ASCVD risk did not change over a 4-year period among predominantly black young PWH, but infection with hepatitis C and dual hepatitis B/C were associated with higher ASCVD risk scores. Our findings illustrate the need for further longitudinal studies evaluating change in cardiovascular disease (CVD) risk and investigating viral hepatitis as an added potential contributor to increased CVD risk in high-risk, vulnerable populations.
引言
与未感染艾滋病毒的人相比，感染艾滋病毒的人（PWH）患动脉粥样硬化性心血管疾病（ASCVD）的风险更高，但其风险增加的原因仍不明确。我们研究了4年期间ASCVD风险评分的变化，以确定与风险评分变化或高风险评分相关的临床因素。
方法
我们对伊芙琳·乔丹中心40至75岁、至少有两次常规艾滋病毒就诊记录的PWH进行回顾性分析，开展了一项初步研究。我们收集了临床和人口统计学数据，并使用合并队列方程计算ASCVD风险评分。探索性分析研究了风险评分类别随时间的变化。最终的校正分析研究了与连续风险评分随时间变化相关的因素。
结果
我们的样本包括187名PWH；166人为黑人/非裔美国人，79人为女性。我们发现ASCVD风险评分随时间没有显著变化。丙型肝炎患者的风险评分显著更高（7.34%；95%置信区间：2.59，12.09；p = 0.003），与未感染肝炎的患者相比，同时感染乙型和丙型肝炎以及感染乙型肝炎的患者的风险评分有升高趋势（p = 0.07）。
结论
我们发现，在以黑人为主的年轻PWH群体中，ASCVD风险在4年期间没有变化，但丙型肝炎感染以及乙型和丙型肝炎双重感染与更高的ASCVD风险评分相关。我们的研究结果表明，需要进一步开展纵向研究，评估心血管疾病（CVD）风险的变化，并调查病毒性肝炎作为高风险、易感染人群CVD风险增加的一个潜在因素。
引言
与未感染艾滋病毒的人相比，感染艾滋病毒的人（PWH）患动脉粥样硬化性心血管疾病（ASCVD）的风险更高，但其风险增加的原因仍不明确。我们研究了4年期间ASCVD风险评分的变化，以确定与风险评分变化或高风险评分相关的临床因素。
方法
我们对伊芙琳·乔丹中心40至75岁、至少有两次常规艾滋病毒就诊记录的PWH进行回顾性分析，开展了一项初步研究。我们收集了临床和人口统计学数据，并使用合并队列方程计算ASCVD风险评分。探索性分析研究了风险评分类别随时间的变化。最终的校正分析研究了与连续风险评分随时间变化相关的因素。
结果
我们的样本包括187名PWH；166人为黑人/非裔美国人，79人为女性。我们发现ASCVD风险评分随时间没有显著变化。丙型肝炎患者的风险评分显著更高（7.34%；95%置信区间：2.59，12.09；p = 0.003），与未感染肝炎的患者相比，同时感染乙型和丙型肝炎以及感染乙型肝炎的患者的风险评分有升高趋势（p = 0.07）。
结论
我们发现，在以黑人为主的年轻PWH群体中，ASCVD风险在4年期间没有变化，但丙型肝炎感染以及乙型和丙型肝炎双重感染与更高的ASCVD风险评分相关。我们的研究结果表明，需要进一步开展纵向研究，评估心血管疾病（CVD）风险的变化，并调查病毒性肝炎作为高风险、易感染人群CVD风险增加的一个潜在因素。
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