title: Ischemic heart disease in HIV-infected and HIV-uninfected individuals: a population-based cohort study.
abstract: BACKGROUND
  There are concerns about highly active antiretroviral therapy (HAART) causing a progressive increase in the risk of ischemic heart disease. We examined this issue in a nationwide cohort study of patients with human immunodeficiency virus (HIV) infection and a population-based control group.
  
  
  METHODS
  We determined the rate of first hospitalization for ischemic heart disease in all Danish patients with HIV infection (3953 patients) from 1 January 1995 through 31 December 2004 and compared this rate with that for 373,856 subjects in a population-based control group. Data on first hospitalization for ischemic heart disease and comorbidity were obtained from the Danish National Hospital Registry for all study participants. We used Cox's regression to compute the hospitalization rate ratio as an estimate of relative risk, adjusting for comorbidity.
  
  
  RESULTS
  Although the difference was not statistically significant, patients with HIV infection who had not initiated HAART were slightly more likely to be hospitalized for the first time with ischemic heart disease than were control subjects (adjusted relative risk, 1.39; 95% confidence interval, 0.81-2.33). After HAART initiation, the risk increase became substantially higher (adjusted relative risk, 2.12; 95% confidence interval, 1.62-2.76), but the relative risk did not further increase in the initial 8 years of HAART.
  
  
  CONCLUSIONS
  Compared with the general population, HIV-infected patients receiving HAART have an increased risk of ischemic heart disease, but the relative risk is stable up to 8 years after treatment initiation.
authors.affiliation: Department of Infectious Diseases, Rigshospitalet, Hvidovre, Denmark. niels.obel@ouh.fyns-amt.dk
authors.forename: Niels
authors.initials: N
authors.lastname: Obel
authors.forename: Henrik F
authors.initials: HF
authors.lastname: Thomsen
authors.forename: Gitte
authors.initials: G
authors.lastname: Kronborg
authors.forename: Carsten S
authors.initials: CS
authors.lastname: Larsen
authors.forename: Per R
authors.initials: PR
authors.lastname: Hildebrandt
authors.forename: Henrik T
authors.initials: HT
authors.lastname: Sørensen
authors.forename: Jan
authors.initials: J
authors.lastname: Gerstoft
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D012189:Retrospective Studies; D012306:Risk