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1: Clin Infect Dis. 2007 Oct 15;45(8):1074-81. Epub 2007 Sep 12.
Ten-year predicted coronary heart disease risk in HIVinfected men and women.
Kaplan RC, Kingsley LA, Sharrett AR, Li X, Lazar J, Tien PC, Mack WJ, Cohen
MH, Jacobson L, Gange SJ.
Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY 10461,
USA. [email protected]
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 > or = 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 > or = 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.
PMID: 17879928 [PubMed - in process]