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. 2011 Jul;4(4):425-32.
doi: 10.1161/CIRCOUTCOMES.110.957415. Epub 2011 Jun 28.

The risk of incident coronary heart disease among veterans with and without HIV and hepatitis C

Matthew S Freiberg  1 , Chung-Chou H Chang, Melissa Skanderson, Kathleen McGinnis, Lewis H Kuller, Kevin L Kraemer, David Rimland, Matthew B Goetz, Adeel A Butt, Maria C Rodriguez Barradas, Cynthia Gibert, David Leaf, Sheldon T Brown, Jeffrey Samet, Lewis Kazis, Kendall Bryant, Amy C Justice; Veterans Aging Cohort Study
Affiliations

The risk of incident coronary heart disease among veterans with and without HIV and hepatitis C

Matthew S Freiberg et al. Circ Cardiovasc Qual Outcomes. 2011 Jul.

Abstract

Background: Whether hepatitis C virus (HCV) confers additional coronary heart disease (CHD) risk among human immunodeficiency virus (HIV) infected individuals is unclear. Without appropriate adjustment for antiretroviral therapy, CD4 count, and HIV-1 RNA and substantially different mortality rates among those with and without HIV and HCV infection, the association between HIV, HCV, and CHD may be obscured.

Methods and results: We analyzed data on 8579 participants (28% HIV+, 9% HIV+HCV+) from the Veterans Aging Cohort Study Virtual Cohort who participated in the 1999 Large Health Study of Veteran Enrollees. We analyzed data collected on HIV and HCV status, risk factors for and the incidence of CHD, and mortality from January 2000 to July 2007. We compared models to assess CHD risk when death was treated as a censoring event and as a competing risk. During the median 7.3 years of follow-up, there were 194 CHD events and 1186 deaths. Compared with HIV-HCV- Veterans, HIV+HCV+ Veterans had a significantly higher risk of CHD regardless of whether death was adjusted for as a censoring event (adjusted hazard ratio, 2.03; 95% confidence interval, 1.28 to 3.21) or a competing risk (adjusted HR, 2.45; 95% confidence interval, 1.83 to 3.27 respectively). Compared with HIV+HCV- Veterans, HIV+HCV+ Veterans also had a significantly higher adjusted risk of CHD regardless of whether death was treated as a censored event (adjusted hazard ratio, 1.93; 95% confidence interval, 1.02 to 3.62) or a competing risk (adjusted hazard ratio, 1.46; 95% confidence interval, 1.03 to 2.07).

Conclusions: HIV+HCV+ Veterans have an increased risk of CHD compared with HIV+HCV- and HIV-HCV- Veterans.

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Conflict of interest statement

Conflict of Interest Disclosures: None

Figures

Figure 1
Figure 1
presents adjusted survival curves from Cox proportional hazard models among HIV+ and HIV− Veterans and the risk of CHD The solid line represents risk for HIV+ Veterans. The dotted line represents risk for the HIV− Veterans. *All participants who were censored had variable time to follow up based on their last recorded encounter.
Figure 2
Figure 2
presents adjusted survival curves from Cox proportional hazard models among HIV+HCV+, HIV+HCV−, HIV−HCV+, and HIV−HCV− Veterans and the risk of CHD The solid line represents the risk for HIV+HCV+ Veterans. The long dash line represents the risk for HIV+HCV− Veterans. The short dash line represents the risk for HIV−HCV+ Veterans. The dotted line represents the risk for HIV−HCV− Veterans. *All participants who were censored had variable time to follow up based on their last recorded encounter.
See this image and copyright information in PMC

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