3rd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 23-26 October 2001, Athens, Greece

ACCELERATED ATHEROSCLEROSIS IN MEN INFECTED WITH HIV

Antiviral Therapy 2001; 6(Suppl. 4):36 (abstract no. 49)

¹J Currier, F Boyd², B Burtce³, C Dezii³, H Kawabata³, D Lilienfeld³ and S Hodder^3
1 University of California at Los Angeles, Center for Clinical AIDS Research and Education, LosAngeles, Calif., USA;² Johns Hopkins University, The Bloomberg School of Public Health, Baltimore, MD., USA; and ³ Bristol-Myers Squibb, Princeton, NJ, USA

BACKGROUND: Interest in coronary heart disease (CHD) in individuals infected with HIV is a topic of current concern and discussion.

OBJECTIVE: Medi-Cal claims from July 1994 to June 2000 were examined for CHD rates in men over age 18 with and without evidence of HIV diagnosis and/or treatment.

METHODS: Men were included in the HIV-infected group if a claim used ICD-9 codes 042, 079.5 or V08. Individuals were defined as having CHD if a claim used ICD-9 codes 410, 411, 413 and 414.0. To assess only individuals with new CHD diagnoses, men had to be free of CHD-related claims for at least 1 year prior to study inclusion.

RESULTS: Of patients with claims, 23672 men with HIV and 1004703 men without HIV were studied. We determined person-year estimates of non-HIV Medi- Cal eligible patients without claims using Medi-Cal Annual Statistical Reports. Using log-linear regression analysis, age-specific CHD incidence rates per 100 person years for men with and without HIV, respectively, were determined as follows: age 25-34, 1.31 (95% CI 1.07-1.60) in men with HIV and 0.64 (95% CI 0.61-0.66) in non-HIV men; age 35-44, 1.51 (95% CI 1.37-1.67) and 1.32 (95% CI 1.29-1.35); age 45-54, 1.82 (95% CI 1.56-2.12) and 2.50 (95% CI 2.45-2.54); age 55-64, 2.65 (95% CI 2.17-3.23) and 5.33 (95% CI 5.25-5.42); and age ≥65, 2.64 (95% CI 2.00-3.55) and 6.17 (95% CI 6.12-6.23). Age-specific relative risks for CHD in individuals with HIV compared to those without HIV range from 2.06 (95% CI 1.68-2.53) for individuals aged 25-34 years to 0.43 (95% CI 0.32-0.58) in individuals 65 and older.

CONCLUSIONS: These data suggest an association between HIV infection and/or therapy and accelerated coronary atherosclerosis in young (but not older) men. Due to this study's lack of data on other important risk factors for CHD, such as smoking, further investigations are clearly needed. Nonetheless, modification of CHD risk factors should be considered in these individuals.

011023
49

Copyright © 2001 - International Medical Press Ltd. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Medical Editor, International Medical Press, 36 St Mary-at-Hill, London EC3R 8DU, United Kingdom.