title: HIV replication and immune status are independent predictors of the risk of myocardial infarction in HIV-infected individuals.
abstract: BACKGROUND
  Individuals infected by human immunodeficiency virus (HIV) have a higher risk of cardiovascular disease than the general population. The specific effects of virological and immunological parameters on the risk of myocardial infarction (MI) in HIV-infected individuals are debated.
  
  
  METHODS
  We conducted a nested case-control study within the French Hospital Database on HIV. Case patients (n = 289) were patients who, between January 2000 and December 2006, had a prospectively recorded and validated first MI. Up to 5 HIV-infected controls (n = 884) matched for age, sex, and clinical center were selected, at random with replacement, among patients with no history of MI. Conditional logistic regression models were used to identify predictors of the risk of MI.
  
  
  RESULTS
  Plasma HIV-1 RNA levels >50 copies/mL, a low CD4 T-cell nadir, and a high CD8 T-cell count were independently associated with an increased risk of MI, with respective odds ratios of 1.51 (95% confidence interval, 1.09-2.10), 0.90 (.83-.97) per log(2) unit, and 1.48 (1.01-2.18) for the highest tertile of CD8 T-cell counts (>1150 cells/mm(3)) compared with the lowest (≤760 cells/mm(3)).
  
  
  CONCLUSIONS
  Independently of cardiovascular risk factors and antiretroviral therapy, HIV replication, a low CD4 T-cell nadir and a high current CD8 T-cell count are associated with an increased risk of MI in HIV-infected individuals. This suggests new paths for interventions to diminish the risk of MI in HIV-infected patients.
authors.affiliation: INSERM U, Paris, France. slang@ccde.chups.jussieu.fr
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lang
authors.forename: Murielle
authors.initials: M
authors.lastname: Mary-Krause
authors.forename: Anne
authors.initials: A
authors.lastname: Simon
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Partisani
authors.forename: Jacques
authors.initials: J
authors.lastname: Gilquin
authors.forename: Laurent
authors.initials: L
authors.lastname: Cotte
authors.forename: Franck
authors.initials: F
authors.lastname: Boccara
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
mesh_terms: D000328:Adult; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000502:physiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000276:immunology / Q000821:virology*; D012367:RNA, Viral / Q000097:blood; D018570:Risk Assessment; D019562:Viral Load; D014779:Virus Replication / Q000502:physiology*
chemical_list: D012367:RNA, Viral