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Ph.D. Student
Enrolment
Project Title
: Line Dahlerup Rasmussen
: 1.okt. 2008
: HIV and risk of venous thromboembolism: A Danish nationwide populationbased cohort study
Supervisors
: Professor, overlæge, Dr.Med. Court Pedersen1, Overlæge, Dr.Med. Niels Obel 2
Institute
: Institute of Clinical Research
Research Unit : Infectious Diseases
Authors:
Line Dahlerup Rasmussen1, Merete Dybdal3, Jan Gerstoft2, Gitte Kronborg4, Carsten Schade
Larsen5, Court Pedersen1, Gitte Pedersen6, Janne Jensen7, Lars Pedersen3, Henrik Toft
Sørensen3,8, Niels Obel2
1Department of Infectious Diseases, Odense University Hospital, Odense, Denmark,
2Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark
3Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Denmark
4Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
5Department of Infectious Diseases, Aarhus University Hospital, Skejby, Denmark,
6Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark,
7Department of Infectious Diseases, Kolding Sygehus, Kolding, Denmark
8Department of Epidemiology, Boston University, Boston, MA, USA
Abstract:
Objective:
The association between HIV and risk of venous thromboembolism (VTE) is controversial. We
examined the risk of VTE in HIV-infected individuals compared to the general population and
estimated the impact of low CD4 count, highly active antiretroviral therapy (HAART) and IV drug
abuse (IDU).
Methods:
We identified 4,333 Danish HIV patients from the Danish HIV Cohort Study and a populationbased age- and gender-matched comparison cohort of 43,330 individuals. VTE diagnoses were
extracted from the Danish National Hospital Registry.
Cumulative incidence curves were constructed for time to first VTE. Incidence rate ratios (IRR) and
impact of low CD4 count and HAART were estimated by Cox regression analyses. Analyses were
stratified by IDU, adjusted for comorbidity and disaggregated by overall, provoked and unprovoked
VTE.
Results:
5 years risk of VTE was 8.0% (95%CI: 5.78-10.74) in IDU HIV patients, 1.5% (95%CI: 1.14-1.95)
in non-IDU HIV patients and 0.3% (95% CI: 0.29-0.41) in the population comparison cohort. In
non-IDU HIV patients, adjusted IRRs for unprovoked and provoked VTE were 3.42 (95% CI: 2.584.54) and 5.51 (95% CI: 3.29-9.23), respectively, compared to the population comparison cohort.
In IDU HIV patients the adjusted IRRs were 12.66 (95% CI: 6.03-26.59) for unprovoked VTE and
9.38 (95% CI: 1.61-54.50) for provoked VTE. Low CD4 count had minor impact on these risk
estimates, while HAART increased the overall risk (adjusted IRR:1.93; 95% CI: 1.00-3.72).
Conclusion:
HIV patients are at increased risk of VTE especially in the IDU population. HAART and potentially
low CD4 count further increase the risk.
Keywords: Immunology, Allergology, Microbiology and Infection