Cardiovascular Risk Assessment in Persons with HIV

Module References

  • Aberg JA, Gallant JE, Ghanem KG, et al. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014;58(1):1-10.
  • Armah KA, Chang CC, Baker JV, et al. Prehypertension, hypertension, and the risk of acute myocardial infarction in HIV-infected and -uninfected veterans. Clin Infect Dis. 2014;58:121-129.
  • Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the Prospective Cardiovascular Münster (PROCAM) study. Circulation. 2002;105:310-315.
  • Bavry A, Bhatt D, Kumbhani D. American College of Cardiology. Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk – FOURIER. 16 April 2018. Available at: http://www.acc.org/latest-in-cardiology/clinical-trials/2017/03/16/00/46.... Accessed May 29, 2018.
  • Bedimo RJ, Westfall AO, Drechsler H, Vidiella G, Tebas P. Abacavir use and risk of acute myocardial infarction and cerebrovascular events in the highly active antiretroviral therapy era. Clin Infect Dis. 2011;53:84-91.
  • Brion JM, Rose CD, Nicholas PK, et al. Unhealthy substance-use behaviors as symptom-related self-care in persons with HIV/AIDS. Nurs Health Sci. 2011;13:16-26.
  • Butt AA, Chang CC, Kuller L, et al. Risk of heart failure with human immunodeficiency virus in the absence of prior diagnosis of coronary heart disease. Arch Intern Med. 2011;171:737-743.
  • Chibanda D, Benjamin L, Weiss HA, et al. Mental, neurological, and substance use disorders in people living with HIV/AIDS in low- and middle-income countries. J Acquir Immune Defic Syndr. 2014;67(suppl 1):S54-S67.
  • Clement ME, Park LP, Navar AM, et al. Statin utilization and recommendations among HIV- and HCV-infected veterans: a cohort study. Clin Infect Dis. 2016;63:407-413.
  • Cioe PA, Baker J, Kojic EM, et al. Elevated soluble CD14 and  lower D-dimer are associated with cigarette smoking and heavy episodic alcohol use in  patients living with HIV. J Acquir Immune Defic Syndr. 2015 Dec 1;70(4):400-5.
  • Conroy RM, Pyörälä K, Fitzgerald AP, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24:987-1003.
  • DAD Study Group. Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med. 2007;356:1723-1735.
  • Deeks S, Lewin SR, Havlir DA. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;283:1525-1533.
  • Ding X, Andraca-Carrera E, Cooper C, et al. No association of abacavir use with myocardial infarction: findings of an FDA meta-analysis. J Acquir Immune Defic Syndr. 2012;61:441-447.
  • Dirajlal-Fargo S, Webel AR, Longenecker CT, et al. The effect of physical activity on cardiometabolic health and inflammation in treated HIV infection. Antivir Ther. 2016;21:237-245.
  • Drozd, DR, Kitahata MM, Althoff KN, et al. Increased risk of myocardial infarction in HIV-infected individuals in North America compared with the general population. J Acquir Immune Defic Syndr. 2017 Aug 15;75(5):568-576.
  • Elion RA, Althoff KN, Zhang J, et al. Recent abacavir use increases risk for Types 1 and 2 myocardial infarctions among adults with HIV. J Acquir Immune Syndr. 2018 Feb 6. doi:10.1097/QAI.0000000000001642. [Epub ahead of print].
  • El-Sadr WM, Lundgren J, Neaton JD, et al. CD4+ Count-guided interruption of antiretroviral treatment. New Engl J Med. 2006;355:2283-2296.
  • Everett BM, Smith RJ, Hiatt WR. Reducing LDL with PCSK9 Inhibitors — the clinical benefit of lipid drugs. N Engl J Med. 2015;373:1588-1591.
  • Fahme SA, Bloomfield GS, Peck R. Hypertension in HIV-infected adults: novel pathophysiologic mechanisms. Hypertension. 2018;72:44-55.
  • Freiberg MS, Chang CC, Kuller LH, Skanderson M, et al. HIV infection and the risk of acute myocardial infarction. JAMA Intern Med. 2013;173:614-622.
  • Freiberg MS, Chang CH, Skanderson M, et al. Association between HIV infection and the risk of heart failure with reduced ejection fraction and preserved ejection fraction in the antiretroviral therapy era: results from the Veterans Aging Cohort Study. JAMA Cardiol. 2017;2:536-546.
  • Freiberg MS, McGinnis KA, Kraemer K, et al. The association between alcohol consumption and prevalent cardiovascular diseases among HIV-infected and HIV-uninfected men. J Acquir Immune Defic Syndr. 2010;53:247-253.
  • Feinstein MJ, Bahiru E, Achenbach C, et al. Patterns of cardiovascular mortality for HIV-infected adults in the United States: 1999 to 2013. Am J Cardiol. 2016;117:214-220.
  • Feinstein MJ, Hsue PY, Benjamin LA, et al. Characteristics, prevention and management of cardiovascular disease in people living with HIV. A scientific statement from the American Heart Association. Circulation. 2019;140:e98-e124.
  • Feinstein MJ, Nance RM, Drozd DR, et al.  Assessing and refining myocardial infarction risk estimation among patients with human immunodeficiency virus: a study by the Centers for AIDS Research Network of Integrated Clinical Systems. JAMA Cardiol. 2017;2:155-162.
  • Feinstein MJ, Steverson AB, Ning H, et al. Adjudicated heart failure in HIV-infected and uninfected men and women. J Am Heart Assoc. 2018;7:e009985.
  • Friis-Møller N, Ryom L, Smith C, et al. An updated prediction model of the global risk of cardiovascular disease in HIV-positive persons: the Data-Collection on Adverse Effects of Anti-HIV Drugs (D:A:D) study. Eur J Prev Cardiol. 2016;23:214-223.
  • Friis-Moller, Sabin C, Weber R, et al. Combination antiretroviral therapy and the risk of myocardial infarction. N Engl J Med. 2003;349:1993-2003.
  • Funderburg NT, Jiang Y, Debanne SM, et al. Rosuvastatin reduces vascular inflammation and T cell and monocyte activation in HIV-infected subjects on antiretroviral therapy. J Acquir Immune Defic Syndr. 2015 April 1; 68(4):396-404.
  • Gatell JM, Assoumou L, Moyle G, et al. Switching from a boosted protease inhibitor (PI/r) to a dolutegravir (DTG)-based regimen for maintenance of HIV viral suppression in patients with high cardiovascular risk. AIDS. 2017 Nov 28; 31(18): 2503-2514. Published online 2017 Nov 9.
  • Gelpi M, Afzal S, Lundgren J, et al. Higher risk of abdominal obesity, elevated low-density lipoprotein cholesterol, and hypertriglyceridemia, but not of hypertension, in people living with human immunodeficiency virus (HIV): results from the Copenhagen Comorbidity in HIV Infection Study. Clin Infect Dis. 2018;67:579-586.
  • Greene M, Covinsky K, Astemborski J, et al. The relationship of physical performance with HIV disease and mortality. AIDS. 2014;28:2711-2719.
  • Golomb BA, Evans MA, Dimsdale JE, White HL. Effects of statins on energy and fatigue with exertion: Results from a randomized controlled trial. Arch Intern Med. 2012; 172:1180-1182.
  • Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol [published online ahead of print November 10, 2018]. Circulation. doi: 10.1161/CIR.0000000000000625.
  • Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 PtB):2935-2959.
  • Grandi AM, Nicolini E, Rizzi L, et al. Dyslipidemia in HIV-positive patients: A randomized, controlled, prospective study on ezetimibe  + fenofibrate versus pravastatin monotherapy. J Int AIDS Soc. 2014;17:19004.
  • Grippo AJ, Johnson AK. Biological mechanisms in the relationship between depression and heart disease. Neurosci Biobehav Rev. 2002;26:941-962.
  • Hatleberg CI, Ryom L, El-Sadr W, et al. Gender differences in HIV-positive persons in use of cardiovascular disease-related interventions: D:A:D study. J Int AIDS Soc. 2014 Nov 2;17(4 Suppl 3):19516. doi: 10.7448/IAS.17.4.19516. eCollection.
  • Hunt PW. HIV and inflammation: Mechanisms and consequences. Curr HIV/AIDS Rep. 2012;9:139-147.
  • Joynt KE, Whellan DJ, O'Connor CM. Depression and cardiovascular disease: mechanisms of interaction. Biol Psychiatry. 2003;54:248-261.
  • Khambaty T, Stewart JC, Gupta SK, et al. Association between depressive disorders and incident acute myocardial infarction in human immunodeficiency virus-infected adults: Veterans Aging Cohort Study. JAMA Cardiol. 2016;1:929-937.
  • Krikke M, Hoogeveen RC, Hoepelman AI, et al. Cardiovascular risk prediction in HIV-infected patients: comparing the Framingham, Atherosclerotic Cardiovascular Disease Risk Score (ASCVD), Systematic Coronary Risk Evaluation for the Netherlands (SCORE-NL) and Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) risk prediction models. HIV Med. 2016;17:289-297.
  • Lee SE, Chang HJ, Sung JM, et al. ACC Cardiovasc Imaging. 2018 Oct;11(10):1475-1484.
  • Leyes P, Martinez E, Larrousse M, et al. Effects of ezetimibe on cholesterol metabolism in HIV-infected patients with protease inhibitor-associated dyslipidemia: A single-arm intervention trial. BMC Infect Dis. 2014,11:14:497.
  • Lichtenstein KA, Armon C, Buchacz K, et al. HIV Outpatient Study (HOPS) Investigators. Low CD4+ T cell count is a risk factor for cardiovascular disease events in the HIV outpatient study. Clin Infect Dis. 2010;51:435-447.
  • Lo J, Abbara S, Shturman L, et al. Increased prevalence of subclinical coronary atherosclerosis detected by coronary computed tomography angiography in HIV-infected men. AIDS. 2010;24:243-253.
  • Malee KM, Mellins CA, Huo Y, et al. Prevalence, incidence, and persistence of psychiatric and substance use disorders among mothers living with HIV. J Acquir Immune Defic Syndr. 2014;65:526-534.
  • Martinez E, Larrousse M, Llibre JM, et al. Substitution of raltegravir for ritonavir-boosted protease inhibitors in HIV-infected patients: the SPIRAL study. AIDS. 2010;24:1697-1707.
  • McComsey GA, Kitch D, Daar ES, et al. Inflammation markers after randomization to abacavir/lamivudine or tenofovir/emtricitabine with efavirenz or atazanavir/ritonavir. AIDS. 2012;26:1371-1385.
  • Mdodo R, Frazier E, Dube SR, et al. Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys. Ann Intern Med. 2015 Mar 3;162(5):335-44.
  • Monforte AD, Reiss P, Ryom L, El-Sadr W, et al. Atazanavir is not associated with an increased risk of cardio- or cerebrovascular disease events. AIDS. 2013;27:407-415.
  • Morgello S, Mahboob R, Yakoushina T, Khan S, Hague K. Autopsy findings in human immunodeficiency virus – infected populations over 2 decades. Arch Path Lab Med. 2002;126182-190.
  • Paisible AL, Chang CC, So-Armah KA, et al. HIV infection, cardiovascular disease risk factor profile, and risk for acute myocardial infarction. J Acquir Immune Defic Syndr. 2015;68:209-216.
  • Palella FJ Jr, Baker RK, Moorman AC, et al. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr. 2006;43:27-34.
  • Palella FJ Jr, Fisher M, Tebas P, et al. Simplification to rilpivirine/emtricitabine/tenofovir disoproxil fumarate from ritonavir-boosted protease inhibitor antiretroviral therapy in a randomized trial of HIV-1 RNA-suppressed participants. AIDS. 2014; 28:335-344.
  • Pence BW, Miller WC, Whetten K, et al. Prevalence of DSM-IV-defined mood, anxiety, and substance use disorders in an HIV clinic in the southeastern United States. J Acquir Immune Defic Syndr. 2006;42:298-306.
  • Post WS, et al. Associations between HIV infection and subclinical coronary atherosclerosis. Ann Intern Med. 2014;160:458-467.
  • Raggi P, De Francesco D, Manicardi M, et al. Prediction of hard cardiovascular events in HIV patients. J Antimicrob Chemother. 2016;71:3515-3518.
  • Ramirez-Marrero FA, De Jesus E, Santana-Bagur J, et al. Prevalence of cardiometabolic risk factors in Hispanics living with HIV. Ethn Dis. 2010;20:423-428.
  • Richardson KK, Bokhour B, McInnes DK, et al. Racial disparities in HIV care extend to common comorbidities: implications for implementation of interventions to reduce disparities in HIV care. J Natl Med Assoc. 2016;108:201-210.e3.
  • Ridker PM, Pradhan A, MacFadyen JG, Libby P, Glynn RJ. Cardiovascular benefits and diabetes risks of statin therapy in primary prevention: An analysis from the JUPITER trial. Lancet. 2012;380:565-571.
  • Ryom L, Lundgren JD, El-Sadr WM, et al. Association between cardiovascular disease and contemporarily used protease inhibitors. Lancet HIV. 2018 Jun;5(6):e291-e300.
  • Sabatine MS, Giugliano RP, Keech AC, et al. Evolcumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med. 2017’376”1713-1722.
  • Sabin C, Reiss P, Ryom L, et al. Is there continued evidence for an association between abacavir usage and myocardial infarction risk in individuals with HIV? A cohort collaboration. BMC Med. 2016;14:61.
  • Sabin CA, Ryom L, d’Arminio Monforte A, et al. Abacavir use and risk of recurrent myocardial infarction. AIDS. 2018 ;32(1):78-88.
  • Saeedi R, Johns K, Frohlich J, et al. Lipid lowering efficacy and safety of ezetimibe combined with rosuvastatin compared with titrating rosuvastatin monotherapy in HIV-positive patients. Lipids Health Dis. 2015;14:57.
  • Shah AS, Stezle D, Lee KK, et al. Global burden of atherosclerotic cardiovascular disease in people living with HIV: a systematic review and meta-analysis. Circulation. 2018;138:1100-1112.
  • Sher Y, Lolak S, Maldonado JR. The impact of depression in heart disease. Curr Psychiatry Rep. 2010;12:255-264.
  • Silverberg MJ, Leyden WA, Xu L, et al. Immunodeficiency and risk of myocardial infarction among HIV-positive individuals with access to care. J Acquir Immune Defic Syndr. 2014;65:160-166.
  • Sing S, Willig JH, Mugavero MJ, et al. Comparative efficacy and toxicity among statins in HIV-infected patients. Clin Infect Dis. 2011;52:387-395.
  • Steverson AB, Pawlowski AE, Schneider D, et al. Clinical characteristics of HIV-infected patients with adjudicated heart failure. Eur J Prev Cardiol. 2017;24:1746-1758.
  • Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines [published corrections appear in Circulation. 2014;129(suppl 2):S46–S48 and Circulation. 2015;132:e396]. Circulation. 2014;129(suppl 2)S1-45.
  • Strategies for Management of Anti-Retroviral Therapy/INSIGHT; DAD Study Groups. Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients. AIDS. 2008;22:F17-F24.
  • Strategies for Management of Antiretroviral Therapy (SMART) Study Group, El-Sadr WM, Lundgren J, Neaton JD, et al. CD4+ Count-guided interruption of antiretroviral treatment. New Engl J Med. 2006;355:2283-2296.
  • Subramanian S, Tawakol A, Burdo TH, et al. Arterial inflammation in patients with HIV. JAMA. 2012;308:379-386.
  • Subramanya V, McKay HS, Brusca RM, et al. Inflammatory biomarkers and subclinical carotid atherosclerosis in HIV-infected and HIV-uninfected me in the Multicenter AIDS Cohort Study. PLoS One. 2019 Apr 4;14(4):e0214735.
  • Tenorio AR, Zheng Y, Bosch RJ, et al. Soluble markers of inflammation and coagulation but not activation predict non-AIDS-defining morbid events during suppressive antiretroviral treatment. J Infect Dis. 2014 Oct 15;210(8):1248-59.
  • Thompson-Paul AM, Lichtenstein KA, Armon C, et al. Cardiovascular disease risk prediction in the HIV Outpatient Study. Clin Infect Dis. 2016;63:1508-1516.
  • Torriani FJ, Komarow L, Parker RA, et al. Endothelial function in human immunodeficiency virus-infected antiretroviral naïve subjects before and after starting potent antiretroviral therapy: The ACTG (AIDS Clinical Trials Group) Study 5152s. J Am Coll Cardiol. 2008;52:569-576.
  • Triant VA, Lee H, Hadigan C, Grinspoon SK. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab. 2007;92:2506-2512.
  • Triant VA, Meigs JB, Grinspoon SK. Association of c-reactive protein and HIV infection with acute myocardial infarction. J Acquir Immune Defic Syndr. 2009;51:268-273.
  • Triant VA, Perez J, Regan S, et al. Cardiovascular risk prediction functions underestimate risk in HIV infection. Circulation. 2018;137:2203-2214.
  • Triant VA, Regan S, Lee H, et al. Association of immunologic and virologic factors with myocardial infarction rates in a US healthcare system. J Acquir Immune Defic Syndr. 2010;55:615-619.
  • Vancampfort D, Mugisha J, Rosenbaum S, et al. Cardiorespiratory fitness levels and moderators in people with HIV: a systematic review and meta-analysis. Prev Med. 2016;93:106-114.
  • Webel AR, Perazzo J, Longenecker CT, et al. The influence of exercise on cardiovascular health in sedentary adults with human immunodeficiency virus. J Cardiovasc Nurs. 2018;33:239-247.
  • White JR, Chang CC, So-Armah KA, et al. Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans: Veterans Aging Cohort Study. Circulation. 2015;132:1630-1638.
  • Womack JA, Chang CC, So-Armah KA, et al. HIV infection and cardiovascular disease in women. J Am Heart Assoc. 2014;3:e001035.
  • Worm S, Sabin C, Weber R, et al. DAD Study Group. Risk of myocardial infarction in patients with HIV infection exposed to specific individual antiretroviral drugs from 3 major drug classes. J Infect Dis. 2010;201:318-330.
  • Xu Y, Chen X, Wang K. Global prevalence of hypertension among people living with HIV: a systematic review and meta-analysis. J Am Soc Hypertens. 2017;11:530-540.
  • Yen YF, Ko MC, Yen MY, et al. Human Immunodeficiency Virus Increases the Risk of  Incident Heart Failure. J Acquir Immune Defic Syndr 2019;80:255-2.
  • Young J, Xiao Y, Moodier EE, et al. Effect of cumulating exposure to abacavir on the risk of cardiovascular disease events in patients from the Swiss HIV Cohort Study. J Acquir Immune Defic Syndr. 2015;69:413-421.
  • Bush K, Teel J, Watts J, Alvarado G, Gore R, Okulicz J. Endothelial dysfunction is common in early HIV infection and is reversible with ART. Conference on Retroviruses and Opportunistic Infections (CROI). March 4-7, 2019. Seattle. Abstract 655.
  • Crothers K, Harding BN, Whitney BM, et al. COPD and the risk of MI by type in people living with HIV. Conference on Retroviruses and Opportunistic Infections (CROI). March 4-7, 2019. Seattle. Abstract 31.
  • Go AS, Horberg M, Reynolds K, et al. HIV infection independently increases the risk of developing heart failure: The HIV HEART study. AIDS 2018: 22nd International AIDS Conference, Amsterdam, Netherlands, July 23-27, 2018. Abstract THAB0103.
  • O’Halloran JA, Sahrmann JM, Butler AM, et al. Lower cardiovascular disease risk associated with integrase inhibitors. Conference on Retroviruses and Opportunistic Infections (CROI). March 4-7, 2019. Seattle. Abstract 680.
  • Palella FJ, Althoff KN, Moore RD, et al. Abacavir use and risk for myocardial infarction in the NA-ACCORD. Program and abstracts of the 2015 Conference on Retroviruses and Opportunistic Infections; February 23-26, 2015; Seattle, Washington. Abstract 749LB.
  • Post WS, Haberlen S, Zhang L, et al. HIV infection is associated with progression of high risk coronary plaque in the MACS. CROI. 2018. March 3-5, 2018. Boston, MA. Abstract 77. 

 

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The American Academy of HIV Medicine is a professional organization that supports the HIV practitioner and promotes accessible, quality care for all Americans living with HIV disease. Our membership of HIV practitioners and credentialed HIV Specialists™, HIV Experts™, and HIV Pharmacists™ provide direct care to the majority of HIV patients in the US.