Projecting 10-year, 20-year, and Lifetime Risks of Cardiovascular Disease in Persons Living With Human Immunodeficiency Virus in the United States
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Background: Cardiovascular disease (CVD) is an increasing cause of morbidity among persons living with human immunodeficiency virus (HIV; PLWH). We projected cumulative CVD risk in PLWH in care compared to the US general population and persons HIV-uninfected, but at high risk for HIV. Methods: We used a mathematical model to project cumulative CVD incidence. We simulated a male and female cohort for each of 3 populations: US general population; HIV-uninfected, at high risk for HIV; and PLWH. We incorporated the higher smoking prevalence and increased CVD risk due to smoking into the HIV-infected and HIV-uninfected, at high risk for HIV populations. We incorporated HIV-attributable CVD risk, independent of smoking. Results: For men, life expectancy ranged from 70.2 to 77.5 years and for women from 67.0 to 81.1 years (PLWH, US general population). Without antiretroviral therapy, lifetime CVD risk for HIV-infected males and females was 12.9% and 9.0%. For males, by age 60, cumulative CVD incidence was estimated at 20.5% in PLWH in care, 14.6% in HIV-uninfected high-risk persons, and 12.8% in the US general population. For females, cumulative CVD incidence was projected to be 13.8% in PLWH in care, 9.7% for high-risk HIV-uninfected persons, and 9.4% in the US general population. Lifetime CVD risk was 64.8% for HIV-infected males compared to 54.8% for males in the US general population, but similar among females. Conclusions: CVD risks should be a part of treatment evaluation among PLWH. CVD prevention strategies could offer important health benefits for PLWH and should be evaluated.
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HAART does not protect patients from persistent immune activation, chronic inflammation, and excess risk of developing CVD and frailty.
“However, this therapy does not protect patients from the persistent immune activation, chronic inflammation, and excess risk of developing CVD and frailty131–135.”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [133]
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Self-citation
- Authors
- Losina, E., Hyle, E. P., Borre, E. D., Linas, B. P., Sax, P. E., Weinstein, M. C., Rusu, C., Ciaranello, A. L., Walensky, R. P., & Freedberg, K. A.
- Affiliations
- Boston University (US)
- Massachusetts General Hospital (US)
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Corresponding author
- Losina, Elena
- ORCID
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-06-12
- Volume
- 65
- Issue
- 8
- Pages
- 1266-1271
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC5850036
- OpenAlex
- W2625907129
- Cited by
- 62
- References
- 45
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 5 · 2021: 11 · 2020: 3 · 2019: 6 · 2018: 10 · 2017: 5
- FWCI
- 8.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NIH (R01 AI042006, T32 AI007433, K01 HL123349, R01 DA031059, P30 DA040500, P30 AI069354, P30 AI042853)
- Topics
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- cardiovascular disease, HIV, lifetime cardiovascular risk, smoking, antiretroviral therapy, cardiovascular disease prevention, life expectancy, sex differences
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Female, Humans, Life Expectancy, Male, Middle Aged, Risk Factors, Smoking, Models, Statistical, HIV Infections, Incidence, Young Adult
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