The risk of myocarditis in HIV patients is not necessarily Hepatitis C virus (HCV) co-infection, but this risk increases as the patient ages.
A team led by Raynell Lang, MD, MSc, Department of Medicine, University of Calgary, determined whether co-infection with HCV increases the risk of type 1 myocardial infarction and whether risk differs by age.
Although HIV patients are often at increased risk of cardiovascular disease, the impact of HCV co-infection is not yet understood. Several studies have found that HIV-infected patients have a 50-75% increased risk of cardiovascular disease compared to HIV-uninfected patients.
“CVD risk among people infected with hepatitis C virus (HCV) alone is variable, with some studies showing an increased risk and others showing no association,” the authors write. Due to shared pathways, HIV/HCV co-infection is common worldwide (10%–30%), especially in older populations receiving modern antiretroviral therapy (ART). Little is known about the CVD risk of those with PWH.”
Data from North America
In this study, researchers used NA-ACCORD (North American AIDS Cohort Collaboration on Research and Design) data from 2000-2017 for HIV patients aged 40-79 who started antiretroviral therapy. The NA-ACCORD is a collaborative study of 29 clinical and interval cohorts from the United States and Canada and the North American region of the International Epidemiological Database for AIDS Assessment.
Investigators sought the primary outcome of adjudicated type 1 myocarditis events. Patients starting direct-acting HCV antivirals were censored at initiation.
The team then calculated the crude incidence of type 1 myocardium per 1000 person-years for each calendar hour. They also used independent event-onset time analysis with complementary log-logm models to estimate adjusted hazard ratios and His 95% confidence intervals for type 1 myocarditis with and without HCV. Did.
Comparison of patients with and without HCV
Of the 23,361 HIV patients overall, 20% (n = 4,677) were infected with HCV. Eighty-nine (1.9%) patients with type 1 myocarditis had HIV and HCV co-infection, and 314 (1.7%) HIV patients without HCV co-infection had their type 1 myocarditis. rice field.
Results show that HCV is not associated with an increased risk of type 1 myocarditis in HIV patients (aHR, 0.98; 95% CI, 0.74-1.30).
This risk increases with age, increasing in HCV-free patients (aHR per 10-year increase, 1.30; 95% CI, 1.13-1.50) (P. <.001, test for interaction).
“HCV co-infection was not significantly associated with the increase. [type 1 myocarditis infarction] dangerous; however [type 1 myocarditis infarction] HCV status should be considered when assessing age-related cardiovascular disease risk. [people with HIV]” writes the author.
the study, “Assessing cardiovascular risk in an aging population of HIV-infected individuals: the impact of co-infection with hepatitis C virus.‘ was published online. American Heart Association Journal.