Predicting the risk of cardiovascular disease in HIV-infected patients: the Data collection on Adverse Effects of Anti-HIV Drugs Study
Open accessAbstract
AIMS: HIV-infected patients receiving combination antiretroviral therapy may experience metabolic complications, potentially increasing their risk of cardiovascular diseases (CVDs). Furthermore, exposures to some antiretroviral drugs seem to be independently associated with increased CVD risk. We aimed to develop cardiovascular risk-assessment models tailored to HIV-infected patients. METHODS AND RESULTS: Prospective multinational cohort study. The data set included 22,625 HIV-infected patients from 20 countries in Europe and Australia who were free of CVD at entry into the Data collection on Adverse Effects of Anti-HIV Drugs Study. Using cross-validation methods, separate models were developed to predict the risk of myocardial infarction, coronary heart disease, and a composite CVD endpoint. Model performance was compared with the Framingham score. The models included age, sex, systolic blood pressure, smoking status, family history of CVD, diabetes, total cholesterol, HDL cholesterol and indinavir, lopinavir/r and abacavir exposure. The models performed well with area under the receiver operator curve statistics of 0.783 (range 0.642-0.820) for myocardial infarction, 0.776 (0.670-0.818) for coronary heart disease and 0.769 (0.695-0.824) for CVD. The models estimated more accurately the outcomes in the subgroups than the Framingham score. CONCLUSION: Risk equations developed from a population of HIV-infected patients, incorporating routinely collected cardiovascular risk parameters and exposure to individual antiretroviral therapy drugs, might be more useful in estimating CVD risks in HIV-infected persons than conventional risk prediction models.
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HIV-specific indices such as the DAD CV index may be more accurate than the Framingham index in HIV-infected populations.
“While it predicts cardiovascular events, the thresholds may vary from HIV-uninfected populations and may under-estimate risk and HIV-specific indices (e.g., DAD CV index) that may be more accurate (62–64)”
From HIV and Aging: State of Knowledge and Areas of Critical Need for Research. A Report to the NIH Office of AIDS Research by the HIV and Aging Working Group (2012) · cites this paper as [64]
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- Authors
- Friis-Møller, N., Thiébaut, R., Reiss, P., Weber, R., D'Arminio Monforte, A., De Wit, S., El-Sadr, W., Fontas, E., Worm, S., Kirk, O., Phillips, A., Sabin, C. A., Lundgren, J. D., Law, M. G., & DAD study group
- Affiliations
- Copenhagen HIV Programme (CHIP), University of Copenhagen/Faculty of Health Science, Copenhagen, Denmark
- Inserm (FR)
- Amsterdam UMC Location University of Amsterdam (NL)
- University Hospital Zurich (CH)
- ICONA, Hospital San Paolo, University of Milan, Italy
- Saint-Pierre Cohort, CHU Saint-Pierre Hospital, Brussels, Belgium
- Columbia University Irving Medical Center (US)
- Nice Cohort, CHU Nice Hopital de l'Archet, Nice, France
- University of Copenhagen (DK)
- The Royal Free Hospital (GB)
- AHOD, National Centre in HIV Epidemiology and Clinical Research, Sydney, Australia
- ORCID
- Venue
- European Journal of Cardiovascular Prevention & Rehabilitation
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-10
- Volume
- 17
- Issue
- 5
- Pages
- 491-501
- ISSN
- 1741-8267 (ISSN-L)
- OpenAlex
- W2160970334
- Cited by
- 384
- References
- 43
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 13 · 2023: 12 · 2022: 16 · 2021: 28 · 2020: 23 · 2019: 25 · 2018: 16 · 2017: 38 · 2016: 36 · 2015: 43 · 2014: 24 · 2013: 33 · 2012: 34
- FWCI
- 28.09
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- European Journal of Cardiovascular Prevention & Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Murdoch University Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Science Foundation
- Bristol-Myers Squibb
- Pfizer
- GlaxoSmithKline
- Gilead Sciences
- European Commission (BIOMED2, CT94-1637, CT97-2713, QLK2-2000-00773)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- National Institutes of Health
- National Institute of Allergy and Infectious Diseases (U01AI046362, U01AI042170, U01AI069907)
- Cilag
- Topics
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- cardiovascular risk prediction, HIV infection, antiretroviral therapy, highly active antiretroviral therapy, metabolic complications, myocardial infarction, coronary artery disease, indinavir, lopinavir/ritonavir, abacavir, Framingham risk score, cardiovascular risk factors
- MeSH terms
- Adult, Argentina, Australia, Coronary Disease, Drug Therapy, Combination, Europe, Female, Humans, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Risk Factors, Time Factors, Reproducibility of Results, Models, Statistical, HIV Infections, Treatment Outcome, Risk Assessment, Anti-HIV Agents
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