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Comparison of Four Predictive Scores for Cardiovascular Risk in Mexican People with HIV.
- Source :
-
AIDS research and human retroviruses [AIDS Res Hum Retroviruses] 2024 Jul; Vol. 40 (7), pp. 439-448. Date of Electronic Publication: 2024 May 15. - Publication Year :
- 2024
-
Abstract
- Persons with HIV (PWH) face an increased risk of cardiovascular events due to immune activation, comorbidities, and certain antiretrovirals (ARVs). However, the current cardiovascular risk (CVR) scores are not specifically directed toward PWH. This study aimed to assess the agreement between different predictive CVR scores and explore their relationship with clinical and demographic data in Mexican PWH. A descriptive cross-sectional analysis was conducted in 200 PWH with a mean age of 42 years who were treated at a Mexican urban center from 2017 to 2018. The majority (83%) was on ARV treatment and 79.5% had undetectable viral loads (VLs). Moderate- to high-risk scores were infrequent, with Framingham Risk Score for Hard Coronary Heart Disease scores showing higher values, with very low concordance among all scores. Logistic regression analysis revealed significant associations between the CVR scores and the initial recorded VL, CD4 cell count, and elevated triglyceride levels. However, no associations were found with measures such as body mass index or abdominal circumference. Treatment with integrase strand transfer inhibitors (INSTIs), particularly first-generation inhibitors, showed strong associations with all predictive scores, notably ASCVD (odds ratio = 7.03, 95% confidence interval 1.67-29.64). The poor concordance among the CVR scores in PWH highlights the need for a specific score that considers comorbidities and ARV drugs. Despite the relatively young age of the participants, significant correlations were observed between INSTI use, initial VL, CD4 cell count, and triglyceride levels, which are factors not considered in the existing risk scores. Regardless of the actual value of the scores, screening for CVR in PWH is recommended.
- Subjects :
- Humans
Male
Adult
Female
Cross-Sectional Studies
Mexico epidemiology
Middle Aged
Risk Assessment
CD4 Lymphocyte Count
Heart Disease Risk Factors
Risk Factors
Anti-HIV Agents therapeutic use
North American People
HIV Infections drug therapy
HIV Infections complications
HIV Infections epidemiology
Cardiovascular Diseases epidemiology
Viral Load
Subjects
Details
- Language :
- English
- ISSN :
- 1931-8405
- Volume :
- 40
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- AIDS research and human retroviruses
- Publication Type :
- Academic Journal
- Accession number :
- 38666685
- Full Text :
- https://doi.org/10.1089/AID.2023.0085