Ten-year predicted coronary heart disease risk in HIV-infected men and women

被引:156
作者
Kaplan, Robert C.
Kingsley, Lawrence A.
Sharrett, A. Richey
Li, Xiuhong
Lazar, Jason
Tien, Phyllis C.
Mack, Wendy J.
Cohen, Mardge H.
Jacobson, Lisa
Gange, Stephen J.
机构
[1] Yeshiva Univ Albert Einstein Coll Med, Dept Epidemiol, Bronx, NY 10461 USA
[2] Suny Downstate Med Ctr, Dept Med, Brooklyn, NY 11203 USA
[3] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[4] Univ Calif San Francisco, Dept Med, San Francisco, CA USA
[5] San Francisco VA Med Ctr, San Francisco, CA USA
[6] Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA USA
[7] Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA USA
[8] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Infect Dis & Microbiol, Pittsburgh, PA USA
[9] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA
[10] Stroger House, CORE Ctr, Chicago, IL 60612 USA
[11] Stroger House, Dept Med, Chicago, IL 60612 USA
[12] Rush Med Coll, Dept Med, Chicago, IL 60612 USA
关键词
D O I
10.1086/521935
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Highly active antiretroviral therapy (HAART), in addition to traditional vascular risk factors, may affect coronary heart disease (CHD) risk in individuals with human immunodeficiency virus (HIV) infection. Methods. Among HIV-infected (931 men and 1455 women) and HIV-uninfected (1099 men and 576 women) adults, the predicted risk of CHD was estimated on the basis of age, sex, lipid and blood pressure levels, the presence of diabetes, and smoking status. Results. Among HIV-infected men, 2% had moderate predicted risk of CHD (10-year CHD risk, 15%-25%), and 17% had high predicted risk (10-year CHD risk of >= 25% or diabetes). Among HIV-infected women, 2% had moderate predicted CHD risk, and 12% had high predicted CHD risk. Compared with users of protease inhibitor based HAART, the adjusted odds ratio (OR) for moderate-to-high risk of CHD was significantly lower among HAART-naive individuals (OR, 0.57; 95% confidence interval [CI], 0.36-0.89). Users of HAART that was not protease inhibitor based (OR, 0.74; 95% CI, 0.53-1.01) and former HAART users (OR, 0.68; 95% CI, 0.46-1.03) were also less likely than users of protease inhibitor-based HAART to have moderate-to-high CHD risk, although 95% CIs overlapped the null. Low income was associated with increased likelihood of moderate-to-high CHD risk (for annual income <$10,000 vs. >$40,000: OR, 2.32; 95% CI, 1.51-3.56). Elevated body mass index (calculated as weight in kilograms divided by the square of height in meters) predicted increased likelihood of moderate-to-high CHD risk (for BMI of 18.5-24.9 vs. BMI of 25-30: OR, 1.41 [95% CI, 1.03-1.93]; for BMI of 18.5-24.9 vs. BMI >= 30: OR, 1.79 [95% CI, 1.25-2.56]). Conclusions. Among HIV-infected adults, in addition to antiretroviral drug exposures, being overweight and having a low income level were associated with increased predicted CHD risk. This suggests a need to target HIV-infected men and women with these characteristics for vascular risk factor screening.
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收藏
页码:1074 / 1081
页数:8
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