Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 30;15(3):e0230730.
doi: 10.1371/journal.pone.0230730. eCollection 2020.

Cardiovascular risk factors in HIV infected individuals: Comparison with general adult control population in Greece

Giota Touloumi  1 , Natasa Kalpourtzi  1 , Vasileios Papastamopoulos  2 , Vasilios Paparizos  3 , Georgios Adamis  4 , Anastasia Antoniadou  5 , Maria Chini  6 , Argiro Karakosta  1 , Konstantinos Makrilakis  7 , Magda Gavana  8 , Apostolos Vantarakis  9 , Mina Psichogiou  10 , Simeon Metallidis  11 , Nikolaos V Sipsas  12 , Helen Sambatakou  13 , Christos Hadjichristodoulou  14 , Paraskevi V Voulgari  15 , George Chrysos  16 , Charalambos Gogos  17 , Grigoris Chlouverakis  18 , Grigoris Tripsianis  19 , Yannis Alamanos  20 , George Stergiou  21 ; AMACS and EMENO
Affiliations

Cardiovascular risk factors in HIV infected individuals: Comparison with general adult control population in Greece

Giota Touloumi et al. PLoS One. .

Abstract

Background: Although combined antiretroviral therapy has substantially improved the prognosis of people living with HIV (PLHIV), mortality remains higher compared to the general population, mainly due to higher prevalence of non-HIV-related comorbidities, including cardiovascular diseases (CVD). We assessed the prevalence of CVD risk and its contributing factors in adult PLHIV versus general population controls in Greece.

Settings: Cross-sectional comparison of PLHIV (Athens-Multicenter-AIDS-Cohort-Study; AMACS) versus general population controls (National health examination survey; EMENO).

Methods: All HIV-infected adults with ≥1 measurement of interest (blood pressure, lipids, glucose, weight, height) between 2012-2014 and all EMENO participants (2014-2016) were included. Ten-year total CVD risk was estimated using the Framingham (FRS) or the Systematic Coronary Risk Evaluation (SCORE) equations.

Results: 5839 PLHIV (median age:41.6 years, 85.4% males) and 4820 controls (median age:48 years, 48.4% males) were included. Adjusting for age, sex and origin, PLHIV were more likely to be current smokers (adjusted OR:1.53 [95% CI:1.35-1.74]) and dyslipidemic (aOR:1.18; [1.04-1.34]), less likely to be obese (aOR:0.44 [0.38-0.52], with no differences in hypertension, diabetes or high (≥20%) FRS but with greater odds of high (≥5%) SCORE (aOR:1.55 [1.05-2.30]). Further adjustment for educational level, anti-HCV positivity and BMI showed higher prevalence of hypertension in PLHIV.

Conclusions: Despite the relative absence of obesity, PLHIV have higher prevalence of traditional CVD risk factors and higher risk of fatal CVD compared to general population. Regular screening and early management of CVD risk factors in PLHIV should be of high priority for CVD prevention.

PubMed Disclaimer

Conflict of interest statement

“GT has received a grant, paid to her institute, from Gilead Sciences Europe to support this study and EU National resources grants and a grant from the Hellenic Diabetes Association, paid to her institute, to support the EMENO study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Gilead Sciences Europe has also supported GT to to participate and present some early results of this study in the 2017 IAS Conference. This does not alter our adherence to PLOS ONE policies on sharing data and materials. GT has also received grants unrelated to this study and paid to her institute from Gilead Sciences Europe, UCL, ECDC, EU and National funds; KM and SL have received grants through Hellenic Diabetes Association supporting the current study from Boehringer Ingelheim, Roche, Abbott, MSD and through their Academic center unrelated to this study from Novo Nordisc Hellas, Sanofi Hellas, Astra Zeneca, Novartis, Boehringer Ingelheim, Pharmaserve Lilly. NVS has received an educational grant, unrelated to this study, from Gilead Greece, through the Special Account for Research Grants of the National and Kapodistrian University of Athens. The rest of the authors declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript”.

Figures

Fig 1
Fig 1. Adjusted odds ratio (OR) and 95% confidence interval (95% CI) of cardiovascular (CVD) risk factors and total CVD risk comparing HIV-infected adults to the general population.
Model 1: adjusted for age, sex and country of origin; Model 2: Model 1 plus additional adjustment for HBsAg(+) or anti-HCV(+) and educational level; Model 3: Model 2 plus additional adjustment for body mass index (BMI). Ten-year risk of fatal and non-fatal CVD using the Framingham risk score (FRS) was calculated for the individuals >20 years whereas 10-year risk of fatal CVD using the Systematic Coronary Risk Evaluation (SCORE) for the non-diabetic individuals >20 years. FRS risk ≥20% or SCORE risk score ≥5% were considered as high risk.
See this image and copyright information in PMC

References

    1. Antiretroviral Therapy Cohort Collaboration. Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet. 2008;372:293–299. 10.1016/S0140-6736(08)61113-7 - DOI - PMC - PubMed
    1. Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med. 1998;338:853–860. 10.1056/NEJM199803263381301 - DOI - PubMed
    1. Legarth RA, Ahlström MG, Kronborg G, Larsen CS, Pedersen C, Pedersen G, et al. Long-term mortality in HIV-infected individuals 50 years or older: A Nationwide, population-based cohort study. J Acquir Immune DeficSyndr.2002;71:213–218. - PubMed
    1. Petoumenos K, Reiss P, Ryom L, Rickenbach M, Sabin CA, El-Sadr W, et al. Increased risk of cardiovascular disease (CVD) with age in HIV‐positive men: a comparison of the D: A: D CVD risk equation and general population CVD risk equations. HIV Med.2014;15:595–603. 10.1111/hiv.12162 - DOI - PubMed
    1. Antiretroviral Therapy Cohort Collaboration. Causes of death in HIV-1-infected patients with antiretroviral therapy, 1996–2006: collaborative analysis of 13 HIV cohort studies. Clin Infect Dis. 2010;50:1387–96. 10.1086/652283 - DOI - PMC - PubMed

Publication types