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

Boun Kim Tan (1, 2, 3) , Mathieu Chalouni (4, 5) , Dominique Salmon Ceron (2, 3) , Alexandre Cinaud (3, 6) , Laure Esterle (4, 5) , Marc Arthur 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)

1 Hôpital Cochin [AP-HP]
2 CHU Paris Centre - Hôpitaux Universitaires Paris Centre
3 UPD5 - Université Paris Descartes - Paris 5
4 INSERM U1219 - UB - ISPED - Team MORPH3EUS
5 UB - Université de Bordeaux
6 Hôtel-Dieu
7 CHU Pitié-Salpêtrière [AP-HP]
8 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
9 Hôpitaux Sud - Hôpital Sainte-Marguerite [CHU - APHM]
10 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
11 Hôpital Pellegrin
12 CHU Tenon [AP-HP]
13 Hôpital Saint-André
14 Hôpital l'Archet
15 UNSA - Université de Nice Sophia-Antipolis
16 CHU Saint-Antoine [AP-HP]
17 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
18 Hôpital Avicenne [AP-HP]
19 Université Sorbonne Paris Nord
20 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
21 AP-HP - Hopital Saint-Louis [AP-HP]
22 PHARMA-DEV - Pharmacochimie et Biologie pour le Développement
23 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
24 Université Paris-Saclay
25 Hôpital de la Croix-Rousse [CHU - HCL]
26 Centre Hospitalier Saint Jean de Perpignan
27 Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU)
28 Hôpital Henri Mondor
29 Hôpital Foch [Suresnes]
30 CIC Nantes - Centre d’Investigation Clinique de Nantes
31 Hôpital Haut-Lévêque [CHU Bordeaux]
32 Le Trait d'Union, centre de soins de l'infection par le VIH [CHU Strasbourg]
33 CHU Dijon
34 UB - Université de Bourgogne
35 AP-HP - Hôpital Antoine Béclère [Clamart]
36 CHU Reims - Hôpital universitaire Robert Debré [Reims]
37 CardioVir - Laboratoire de Virologie Médicale et Moléculaire - EA 4684
38 Immunité Innée - Innate Immunity
39 CHU Bordeaux
40 USPC - Université Sorbonne Paris Cité
41 Pathologies biliaires, fibrose et cancer du foie [CRSA]

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.

Keywords: HIV; hepatitis C virus; coinfection; atherosclerosis; cardiovascular

Domains: Life Sciences [q-bio]

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