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Atherosclerotic Cardiovascular Events in Patients Infected With Human Immunodeficiency Virus and Hepatitis C Virus

Boun Tan 1, 2, 3 Mathieu Chalouni 4, 5 Dominique Ceron 2, 3 Alexandre Cinaud 3, 6 Laure Esterle 4, 5 Marc Loko 4, 5 Christine Katlama 7, 8 Isabelle Poizot-Martin 9, 10 Didier Neau 11, 5 Julie Chas 12 Philippe Morlat 4, 5, 13 Eric Rosenthal 14, 15 Karine Lacombe 8, 16 Alissa Naqvi 14 Karl Barange 17 Olivier Bouchaud 18, 19 Anne Gervais 20 Caroline Lascoux-Combe 21 Daniel Garipuy 17 Laurent Alric 17, 22 Cécile Goujard 23, 24 Patrick Miailhes 25 Hugues Aumaitre 26 Claudine Duvivier 27 Anne Simon 7 Jose-Luis Lopez-Zaragoza 28 David Zucman 29 François Raffi 30 Estibaliz Lazaro 11, 31 David Rey 32 Lionel Piroth 33, 34 François Boué 24, 35 Camille Gilbert 4 Firouzé Bani-Sadr 36, 37 François Dabis 4 Philippe Sogni 3, 1, 38 Linda Wittkop 4, 39 Franck Boccara 16, 40, 41
4 INSERM U1219 - UB - ISPED - Team MORPH3EUS
BPH - Bordeaux population health
41 Inserm UMR_S 938 - Pathologies biliaires, fibrose et cancer du foie
CR Saint-Antoine - Centre de Recherche Saint-Antoine, CHU Saint-Antoine [AP-HP]
Abstract : Background: An increased risk of cardiovascular disease (CVD) was reported in patients coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), without identifying factors associated with atherosclerotic CVD (ASCVD) events. Methods: HIV-HCV coinfected patients were enrolled in the Agence Nationale de Recherches sur le Sida et les hépatites virales (ANRS) CO13 HEPAVIH nationwide cohort. Primary outcome was total ASCVD events. Secondary outcomes were coronary and/or cerebral ASCVD events, and peripheral artery disease (PAD) ASCVD events. Incidences were estimated using the Aalen-Johansen method. Factors associated with ASCVD were identified using cause-specific Cox proportional hazards models. Results: At baseline, median age of the study population (N = 1213) was 45.4 (interquartile range [IQR] 42.1-49.0) years and 70.3% were men. After a median follow-up of 5.1 (IQR 3.9-7.0) years, the incidence was 6.98 (95% confidence interval [CI], 5.19-9.38) per 1000 person-years for total ASCVD events, 4.01 (2.78-6.00) for coronary and/or cerebral events, and 3.17 (2.05-4.92) for PAD ASCVD events. Aging (hazard ratio [HR] 1.06; 95% CI, 1.01-1.12), prior CVD (HR 8.48; 95% CI, 3.14-22.91), high total cholesterol (HR 1.43; 95% CI, 1.11-1.83), high-density lipoprotein cholesterol (HR 0.22; 95% CI, 0.08-0.63), statin use (HR 3.31; 95% CI, 1.31-8.38), and high alcohol intake (HR 3.18; 95% CI, 1.35-7.52) were independently associated with total ASCVD events, whereas undetectable baseline viral load (HR 0.41, 95% CI, 0.18-0.96) was associated with coronary and/or cerebral events. Conclusions: HIV-HCV coinfected patients experienced a high incidence of ASCVD events. Some traditional cardiovascular risk factors were the main determinants of ASCVD. Controlling cholesterol abnormalities and maintaining undetectable HIV RNA are essential to control cardiovascular risk.
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Submitted on : Friday, September 3, 2021 - 4:39:51 PM
Last modification on : Friday, September 17, 2021 - 2:29:19 PM

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Boun Tan, Mathieu Chalouni, Dominique Ceron, Alexandre Cinaud, Laure Esterle, et al.. Atherosclerotic Cardiovascular Events in Patients Infected With Human Immunodeficiency Virus and Hepatitis C Virus. Clinical Infectious Diseases, Oxford University Press (OUP), 2021, 72 (9), pp.e215 - e223. ⟨10.1093/cid/ciaa1014⟩. ⟨inserm-03334384⟩

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