Ten-year predicted coronary heart disease risk in HIV-infected men and women.
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.
Kaplan
Robert C
RC
Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY 10461, USA. rkaplan@aecom.yu.edu
Kingsley
Lawrence A
LA
Sharrett
A Richey
AR
Li
Xiuhong
X
Lazar
Jason
J
Tien
Phyllis C
PC
Mack
Wendy J
WJ
Cohen
Mardge H
MH
Jacobson
Lisa
L
Gange
Stephen J
SJ
D000328:Adult; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active; D001794:Blood Pressure; D015992:Body Mass Index; D003327:Coronary Disease / Q000453:epidemiology*; D003920:Diabetes Mellitus; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D007182:Income; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking
D017320:HIV Protease Inhibitors; D008055:Lipids