People living with HIV are twice as likely to develop cardiovascular disease and the global burden of HIV associated with cardiovascular disease has tripled over the last 2 decades.
Recent research revealed that people living with HIV are twice as likely to develop cardiovascular disease (CVD) and the global burden of HIV associated with CVD has tripled over the last 2 decades.
The study involved a systematic review of 5 databases from inception to August 2016 in order to identify studies of CVD in HIV infection. The researchers conducted a random-effects meta-analysis across 80 studies in order to derive the pooled rate and risk of CVD among those who live with HIV.
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The temporal changes in the population attributable fraction and disability-adjusted life years (DALYs) were estimated from HIV-associated CVD from 1990 to 2015 on a regional and global scale.
“National cardiovascular DALYs associated with HIV for 2015 were derived for 154 of the 193 United Nations member states,” explained the authors. “The main outcome measure was the pooled estimate of the rate and risk of cardiovascular disease in people living with HIV and the national, regional and global estimates of DALYs from cardiovascular disease associated with HIV.”
The results considered data from 793,635 people living with HIV and a total follow-up of 3.5 million person-years, which had a crude rate of CVD of 61.8 per 10,000 person-years. When compared to those without HIV, the risk ratio for CVD was 2.16.
“This study has important implications when planning cardiovascular preventative policies in low resource countries where the burden of HIV remains high and that of cardiovascular disease is growing,” Dr. Anoop Shah, Clinical Lecturer in Cardiology, The University of Edinburgh, said in a statement.
On a global scale, over the last 26 years the global population attributable fraction from CVD due to HIV had increased from 0.36% to 0.92% and DALYs had increased from 0.74 to 2.57 million. Furthermore, the researchers noted the marked regional variation with most DALYs lost in sub-Saharan Africa and the Asia-Pacific regions. However, the highest population attributable fraction and burden was found to be in Swaziland, Botswana, and Lesotho.
“We now have clear evidence that your risk of heart and circulatory disease is doubled if you have HIV,” Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said. “This news will have major public health implications globally, but particularly in developing countries in Africa where the burden of HIV is higher.”
Shah ASV, Stelzle D, Lee KK, et al. Global burden of atherosclerotic cardiovascular disease in people living with the human immunodeficiency virus: a systematic review and meta-analysis. [published online July 2, 2018].
Circulation. doi: 10.1161/CIRCULATIONAHA.117.033369.