Relative risk of cardiovascular disease among people living with HIV : a systematic review and meta‐analysis
Open accessAbstract
Objectives: The aim of this study was to estimate the relative risk of cardiovascular disease ( CVD ) among people living with HIV ( PLHIV ) compared with the HIV ‐uninfected population. Methods: We conducted a systematic review and meta‐analysis of studies from the peer‐reviewed literature. We searched the M edline database for relevant journal articles published before A ugust 2010. Eligible studies were observational and randomized controlled trials, reporting CVD , defined as myocardial infarction ( MI ), ischaemic heart disease, cardiovascular and cerebrovascular events or coronary heart disease among HIV ‐positive adults. Pooled relative risks were calculated for various groupings, including different classes of antiretroviral therapy ( ART ). Results: The relative risk of CVD was 1.61 [95% confidence interval ( CI ) 1.43–1.81] among PLHIV without ART compared with HIV ‐uninfected people. The relative risk of CVD was 2.00 (95% CI 1.70–2.37) among PLHIV on ART compared with HIV ‐uninfected people and 1.52 (95% CI 1.35–1.70) compared with treatment‐naïve PLHIV . We estimate the relative risk of CVD associated with protease inhibitor ( PI )‐, nucleoside reverse transcriptase inhibitor‐ and nonnucleoside reverse transcriptase inhibitor‐based ART to be 1.11 (95% CI 1.05–1.17), 1.05 (95% CI 1.01–1.10) and 1.04 (95% CI 0.99–1.09) per year of exposure, respectively. Not all ART was associated with increased risk; specifically, lopinavir/ritonavir and abacavir were associated with the greater risk and the relative risk of MI for PI ‐based versus non‐ PI ‐based ART was 1.41 (95% CI 1.20–1.65). Conclusion: PLHIV are at increased risk of cardiovascular disease. Although effective in prolonging survival, ART (in particular PI ‐based regimens) is related to further increased risk of CVD events among people at highest initial absolute risk of cardiovascular disease.
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HIV patients have higher risk of cardiovascular events, even higher in those treated with protease inhibitors.
“HIV patients have been found to have a higher risk of cardiovascular events, which was even higher in patients treated with protease inhibitors (Friis‐Moller et al, 2007; Islam et al, 2012; Shah et al, 2018).”
From The struggle of a good friend getting old: cellular senescence in viral responses and therapy (2021) · cites this paper as Islam et al, 2012
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- Authors
- Islam, F., Wu, J., Jansson, J., & Wilson, D.
- Affiliations
- The Kirby Institute Faculty of Medicine University of New South Wales Sydney NSW Australia
- UNSW Sydney (AU)
- Corresponding author
- Wilson, DP
- ORCID
- Venue
- HIV Medicine
- Publisher
- Wiley
- Published
- 2012-03-14
- Volume
- 13
- Issue
- 8
- Pages
- 453-468
- ISSN
- 1464-2662 (ISSN-L)
- 1468-1293
- OpenAlex
- W1677033108
- Cited by
- 432
- References
- 40
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 28 · 2023: 19 · 2022: 31 · 2021: 39 · 2020: 42 · 2019: 28 · 2018: 44 · 2017: 34 · 2016: 40 · 2015: 29 · 2014: 27 · 2013: 26 · 2012: 15
- FWCI
- 6.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- HIV Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Australian Government
- Medical Research Council
- Australian Research Council (DP1093026, FT0991990)
- National Health and Medical Research Council (630495)
- 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 › Infectious Diseases › HIV/AIDS drug development and treatment
- Keywords
- cardiovascular disease, people living with HIV, antiretroviral therapy, protease inhibitors, myocardial infarction, ischemic heart disease, coronary artery disease, cerebrovascular events, lopinavir/ritonavir, abacavir, cardiovascular risk
- MeSH terms
- Adult, Cardiovascular Diseases, Humans, Protease Inhibitors, Risk Factors, HIV Infections, Incidence, Reverse Transcriptase Inhibitors, Anti-Retroviral Agents
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