Hilfiker Anina, Schoepf Isabella C, Avery Emma F, Ledergerber Bruno, Colin-Benoit Eugénie, Riebensahm Carlotta, Marzolini Catia, Kahlert Christian R, Bernasconi Enos, Cavassini Matthias, Marinosci Annalisa, Günthard Huldrych F, Kouyos Roger, Nemeth Johannes, Tarr Philip E
University Center Internal Medicine and Infectious Diseases Service, Kantonsspital Baselland, University of Basel, Bruderholz, Switzerland.
Hepatology, Department for Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
J Acquir Immune Defic Syndr. 2025 Oct 1;100(2):143-146. doi: 10.1097/QAI.0000000000003714.
In tuberculosis medium/high prevalence countries, Mycobacterium tuberculosis (MTB) infection has been associated with acute coronary artery disease (CAD) events and subclinical atherosclerosis. We aimed to examine whether MTB infection contributes to clinical and subclinical CAD in people with HIV in tuberculosis low incidence settings.
Regarding CAD events, cases were Swiss HIV Cohort Study (SHCS) participants with a first CAD event (2000-2022). CAD-free SHCS controls were matched on sex, age, and observation time. Regarding subclinical atherosclerosis, SHCS participants underwent (2013-2019) noncontrast CT for detection of coronary artery calcification (CAC) and coronary CT angiography for the detection of coronary soft, mixed, or high-risk plaque (SMHRP). We obtained univariable/multivariable odds ratios (OR) for CAD events, CAC, and SMHRP, in participants with negative TB status, MTB infection, and active TB, analyzed in the context of traditional and HIV-related CAD risk factors.
We included 465 participants with acute CAD events and 1123 controls (median age 56 years, 14% women, 86% with suppressed HIV RNA). MTB infection was not associated with CAD events in multivariable analysis [Odds ratio (OR) (95% confidence interval), 0.92 (0.55 to 1.52)] vs. participants with negative TB status. In 402 participants undergoing CAC/coronary CT angiography (median age 53 years, 14% women, 96% with suppressed HIV RNA), MTB infection was not associated with SMHRP [OR = 0.55 (0.19 to 1.55)] or with CAC [OR = 0.38 (0.1 to 1.41)] in multivariable analysis.
In people with HIV in Switzerland, a tuberculosis low prevalence country, we found no evidence of any association between MTB infection and acute CAD events or subclinical coronary atherosclerosis.
在结核病中/高流行率国家，结核分枝杆菌（MTB）感染与急性冠状动脉疾病（CAD）事件及亚临床动脉粥样硬化有关。我们旨在研究在结核病低发病率地区，MTB感染是否会导致HIV感染者出现临床和亚临床CAD。
关于CAD事件，病例为瑞士HIV队列研究（SHCS）中首次发生CAD事件（2000 - 2022年）的参与者。无CAD的SHCS对照在性别、年龄和观察时间上进行匹配。关于亚临床动脉粥样硬化，SHCS参与者在2013 - 2019年期间接受了非增强CT以检测冠状动脉钙化（CAC），并接受了冠状动脉CT血管造影以检测冠状动脉软斑块、混合斑块或高危斑块（SMHRP）。我们获得了结核病状态阴性、MTB感染和活动性结核病参与者发生CAD事件、CAC和SMHRP的单变量/多变量比值比（OR），并在传统和HIV相关CAD危险因素的背景下进行分析。
我们纳入了465例急性CAD事件参与者和1123例对照（中位年龄56岁，14%为女性，86%的HIV RNA得到抑制）。与结核病状态阴性的参与者相比，多变量分析中MTB感染与CAD事件无关[比值比（OR）（95%置信区间），0.92（0.55至1.52）]。在402例接受CAC/冠状动脉CT血管造影的参与者中（中位年龄53岁，14%为女性，96%的HIV RNA得到抑制），多变量分析中MTB感染与SMHRP[OR = 0.55（0.19至1.55）]或CAC[OR = 0.38（0.1至1.41）]均无关。
在瑞士这个结核病低流行率国家的HIV感染者中，我们没有发现MTB感染与急性CAD事件或亚临床冠状动脉粥样硬化之间存在任何关联的证据。
