title: Risk of cardiovascular disease in HIV, hepatitis C, or HIV/hepatitis C patients compared to the general population.
abstract: BACKGROUND
  As a result of effective antiretroviral therapy HIV patients are living longer, and their risk of cardiovascular disease (CVD) is a growing concern. It remains unknown whether coinfection with hepatitis C (HCV) changes an HIV person's CVD risk, and how the risks compare to the general population. The objective of this study was to compare the Framingham Risk Score (FRS) and vascular age differences in persons with HIV, HCV or HIV/HCV disease to the general population.
  
  
  METHODS
  HIV, HCV, and HIV/HCV patients with clinic visits between 2004 and 2009 were sampled from medical clinics in Rochester, NY. Uninfected persons were randomly selected from the National Health and Nutrition Examination Survey (NHANES), and individually matched on gender, race, and age. We stratified by infection group and conducted separate multivariable linear regression analyses between each infection group and the gender, race, and age matched participants from NHANES.
  
  
  RESULTS
  Rochester patients (HIV = 239, HCV = 167, HIV/HCV = 182) were compared 3 : 1 with the NHANES participants. After controlling for weight, marital status, current pharmacotherapies and the matching variables of gender, race, and age, HIV/HCV patients had a 2% higher general FRS compared with the general population (p = 0.03), and vascular age differences that were 4.1 years greater (p = .01). HCV patients had a 2.4% higher general FRS than the general population (p < .001), and vascular age differences that were 4.4 years greater (p < .001). CVD risk was elevated but not significantly different between HIV patients and the general population.
  
  
  CONCLUSIONS
  Cardiovascular disease risk is elevated among HIV/HCV and HCV infected persons compared with the general population.
authors.affiliation: Department of Community and Preventive Medicine, University of Rochester, Rochester, NY, USA. lisa.kakinami@mcgill.ca
authors.forename: L
authors.initials: L
authors.lastname: Kakinami
authors.forename: R C
authors.initials: RC
authors.lastname: Block
authors.forename: M J
authors.initials: MJ
authors.lastname: Adams
authors.forename: S E
authors.initials: SE
authors.lastname: Cohn
authors.forename: B
authors.initials: B
authors.lastname: Maliakkal
authors.forename: S G
authors.initials: SG
authors.lastname: Fisher
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000821:virology*; D060085:Coinfection / Q000150:complications* / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors