Cardiovascular risk factors in HIV infected individuals: Comparison with general adult control population in Greece.,PLOS ONE

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Cardiovascular risk factors in HIV infected individuals: Comparison with general adult control population in Greece.
PLOS ONE ( IF 2.9 ) Pub Date : 2020-03-30 , DOI: 10.1371/journal.pone.0230730
Giota Touloumi ₁ , Natasa Kalpourtzi ₁ , Vasileios Papastamopoulos ₂ , Vasilios Paparizos ₃ , Georgios Adamis ₄ , Anastasia Antoniadou ₅ , Maria Chini ₆ , Argiro Karakosta ₁ , Konstantinos Makrilakis ₇ , Magda Gavana ₈ , Apostolos Vantarakis ₉ , Mina Psichogiou ₁₀ , Simeon Metallidis ₁₁ , Nikolaos V Sipsas ₁₂ , Helen Sambatakou ₁₃ , Christos Hadjichristodoulou ₁₄ , Paraskevi V Voulgari ₁₅ , George Chrysos ₁₆ , Charalambos Gogos ₁₇ , Grigoris Chlouverakis ₁₈ , Grigoris Tripsianis ₁₉ , Yannis Alamanos ₂₀ , George Stergiou ₂₁ ,

Affiliation

Department of Hygiene, Epidemiology & Medical Statistics, Medical School, National & Kapodistrian University of Athens, Athens, Greece.
5th Department of Internal Medicine & Infectious Diseases Unit, Evaggelismos General Hospital, Athens, Greece.
AIDS Unit, Clinic of Venereologic & Dermatologic Diseases, Syngros Hospital, Athens, Greece.
1st Dept of Internal Medicine and Infectious Diseases, Gennimatas General Hospital, Athens, Greece.
4th Dept Of Internal Medicine, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
3rd Dept Of Internal Medicine-Infectious Disease Unit, Red Cross General Hospital, Athens, Greece.
Hellenic Diabetes Association, Medical School, National & Kapodistrian University of Athens, Athens, Greece.
Lab of Primary Health Care, General Medicine & Health Services Research, Medical Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Environmental Health, Medical School, University of Patras, Patras, Greece.
1st Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
1st Internal Medicine Department, Infectious Diseases Unit, Ahepa University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Infectious Diseases Unit, Department of Pathophysiology Laikon Athens General Hospital and Medical School, National and Kapodistrian University of Athens, Athens, Greece.
2nd Dept of Internal Medicine, HIV Unit, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Department of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, Larissa, Greece.
Department of Internal Medicine, Rheumatology Clinic, University of Ioannina, Ioannina, Greece.
Infectious Diseases Unit, Tzaneion General Hospital of Piraeus, Athens, Greece.
Dept of Internal Medicine & Infectious Diseases, Patras University General Hospital, Patras, Greece.
Division of Biostatistics, School of Medicine, University of Crete, Heraklion, Greece.
Department of Medical Statistics, Medical Faculty, Democritus University of Thrace, Alexandroupolis, Greece.
Institute of Epidemiology, Preventive Medicine and Public Health, Corfu, Greece.
Hypertension Center, STRIDE-7, Third department of Medicine, School of Medicine, National & Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece.

Background

Although combined antiretroviral therapy has substantially improved the prognosis of people living with HIV (PLHIV), mortality remains higher compared to the general population, mainly due to higher prevalence of non-HIV-related comorbidities, including cardiovascular diseases (CVD). We assessed the prevalence of CVD risk and its contributing factors in adult PLHIV versus general population controls in Greece.

Settings

Cross-sectional comparison of PLHIV (Athens-Multicenter-AIDS-Cohort-Study; AMACS) versus general population controls (National health examination survey; EMENO).

Methods

All HIV-infected adults with ≥1 measurement of interest (blood pressure, lipids, glucose, weight, height) between 2012–2014 and all EMENO participants (2014–2016) were included. Ten-year total CVD risk was estimated using the Framingham (FRS) or the Systematic Coronary Risk Evaluation (SCORE) equations.

Results

5839 PLHIV (median age:41.6 years, 85.4% males) and 4820 controls (median age:48 years, 48.4% males) were included. Adjusting for age, sex and origin, PLHIV were more likely to be current smokers (adjusted OR:1.53 [95% CI:1.35–1.74]) and dyslipidemic (aOR:1.18; [1.04–1.34]), less likely to be obese (aOR:0.44 [0.38–0.52], with no differences in hypertension, diabetes or high (≥20%) FRS but with greater odds of high (≥5%) SCORE (aOR:1.55 [1.05–2.30]). Further adjustment for educational level, anti-HCV positivity and BMI showed higher prevalence of hypertension in PLHIV.

Conclusions

Despite the relative absence of obesity, PLHIV have higher prevalence of traditional CVD risk factors and higher risk of fatal CVD compared to general population. Regular screening and early management of CVD risk factors in PLHIV should be of high priority for CVD prevention.

中文翻译：

HIV感染者的心血管危险因素：与希腊一般成人对照人群的比较。

背景

尽管联合抗逆转录病毒疗法已大大改善了HIV感染者（PLHIV）的预后，但死亡率仍比普通人群更高，这主要是由于与HIV无关的合并症（包括心血管疾病）的患病率较高。我们评估了成年PLHIV与普通人群控制中CVD风险的患病率及其影响因素。

设定值

PLHIV（雅典-多中心-艾滋病-队列研究； AMACS）与一般人群对照（国家健康检查调查； EMENO）的横断面比较。

方法

纳入了2012–2014年间所有具有≥1兴趣测量值（血压，脂质，葡萄糖，体重，身高）的HIV感染成年人以及所有EMENO参与者（2014–2016年）。使用Framingham（FRS）或系统性冠脉风险评估（SCORE）方程估算十年期总CVD风险。

结果

其中包括5839名PLHIV（中位年龄：41.6岁，男性85.4％）和4820名对照（中位年龄：48岁，男性48.4％）。在对年龄，性别和血统进行调整后，PLHIV更有可能是目前吸烟者（校正后的OR：1.53 [95％CI：1.35-1.74]）和血脂异常（aOR：1.18； [1.04-1.34]），肥胖的可能性较小（aOR：0.44 [0.38–0.52]，在高血压，糖尿病或高（≥20％）FRS方面无差异，但高（≥5％）评分的可能性更大（aOR：1.55 [1.05–2.30]）。就教育水平而言，抗-HCV阳性和BMI显示PLHIV中高血压的患病率更高。