Incidence of Cardiometabolic Diseases in People With and Without Human Immunodeficiency Virus in the United Kingdom: A Population-Based Matched Cohort Study

Abstract

Background Evidence on the risk of cardiovascular disease (CVD) and CVD risk factors in people with human immunodeficiency virus (PWH) is limited. We aimed to identify the risk of composite CVD, individual CVD events, and common risk factors. Methods This was a nationwide, population-based, cohort study comparing adult (≥18 years old) PWH with people without human immunodeficiency virus (HIV) matched on age, sex, ethnicity, and location. The primary outcome was composite CVD comprising stroke, myocardial infarction, peripheral vascular disease, ischemic heart disease, and heart failure. The secondary outcomes were individual CVD events, hypertension, diabetes, chronic kidney disease (CKD), and all-cause mortality. Cox proportional hazard regression models were used to examine the risk of each outcome. Results We identified 9233 PWH and matched them with 35 721 HIV-negative individuals. An increased risk was found for composite CVD (adjusted hazard ratio [aHR], 1.50; 95% confidence interval [CI], 1.28–1.77), stroke (aHR, 1.42; 95% CI, 1.08–1.86), ischemic heart disease (aHR, 1.55; 95% CI, 1.24–1.94), hypertension (aHR, 1.37; 95% CI, 1.23–1.53), type 2 diabetes (aHR, 1.28; 95% CI, 1.09–1.50), CKD (aHR, 2.42; 95% CI, 1.98–2.94), and all-cause mortality (aHR, 2.84; 95% CI, 2.48–3.25). Conclusions PWH have a heightened risk for CVD and common CVD risk factors, reinforcing the importance for regular screening for such conditions.

Health conditions in adults with HIV compared with the general population: A population-based cross-sectional analysis

“…Previous studies, typically of long term cohorts, have found increased risk of cardiovascular disease amongst people with HIV. 19 , 20 In our cross-sectional study focusing on 2015, overall probability of ischaemic cardiovascular disease was not elevated, reflecting perhaps the accumulation of awareness about risks, their pro-active management, earlier initiation of HIV therapy, and availability of HIV therapies with fewer metabolic side effects than in the past. We also observed that adults with HIV had a lower probability of rheumatoid arthritis.…”

Distinct patterns of fasting plasma glucose and lipid profile levels over time in adults tested positive for HIV on HAART in Shanghai, China, revealed using growth mixture models

“…Currently, there is no consensus on the association among HIV infection, ART, and the development of diabetes mellitus (DM) ( 2 ). In several studies ( 4 , 5 ), the association of HIV infection and ART with an increased risk of DM has been suggested with potential mechanisms including chronic inflammation and ART-induced mitochondrial dysfunction ( 6 , 7 ). In contrast, others reached different conclusions ( 8 ).…”

Changing co‐morbidity and increasing deprivation among people living with HIV: UK population‐based cross‐sectional study

“…This extraordinary change in the circumstances of PLHIV in the UK has not been recognized to date, most likely because deprivation information is not reported in annual public health HIV epidemiology data [2]. Although greater levels of deprivation among PLHIV compared with the general population are widely acknowledged [9], we are not aware of studies demonstrating rising deprivation within the PLHIV population. Coupled with the increased age of the 2015 cohort, this raises the possibility that as PLHIV grow older, and agerelated non-communicable conditions arise, increase or become more severe, employment opportunities and economic status suffer, reflected in higher deprivation levels across the cohort as a whole.…”