Journal article
Associations between immune depression and cardiovascular events in HIV infection
AIDS, Vol.27(17), pp.2735-2748
2013
Abstract
Objective: To consider associations between the latest/nadir CD4+ cell count, and time spent with CD4+ cell count less than 200 cells/μl (duration of immune depression), and myocardial infarction (MI), coronary heart disease (CHD), stroke, or cardiovascular disease (CVD) (CHD or stroke) in 33 301 HIV-positive individuals.
Design: Longitudinal cohort study.
Methods: Analyses were undertaken using Poisson regression. To investigate whether analyses of stroke were robust to the type of endpoint, we additionally included stroke-like events and rejected strokes into the stroke endpoint.
Results: Participants experienced 716 MI, 1056 CHD, 303 stroke, and 1284 CVD events. Whereas there was no evidence of a higher MI/CHD risk in those with lower latest/nadir CD4+ cell counts after adjustment [current CD4+ <100 cells/μl: relative rate (95% confidence interval) 0.96 (0.62–1.50) for MI, 0.89 (0.30–2.36) for CHD; nadir CD4+ <100 cells/μl: 1.36 (0.57–3.23) for MI, 0.98 (0.45–2.16) for CHD], stroke and CVD rates were higher in those with a latest CD4+ cell count less than 100 cells/μl [2.26 (1.29–3.94) and 1.14 (0.84–1.56), respectively]. All events occurred less frequently in those who had not experienced immune depression, although evidence for a linear association with duration of immune depression was weak. The association between stroke risk and the latest CD4+ cell count strengthened as stroke-like and rejected strokes were included; conversely, associations with established stroke risk factors weakened.
Conclusion: We do not find strong evidence that HIV-positive individuals with a low CD4+ cell count are more likely to experience MI/CHD. Although strokes appear to occur more commonly at low CD4+ cell counts, this may be partly explained by misclassification or other biases.
Details
- Title
- Associations between immune depression and cardiovascular events in HIV infection
- Authors/Creators
- C.A. Sabin (Author/Creator)L. Ryom (Author/Creator)S. De Wit (Author/Creator)A. Mocroft (Author/Creator)A.N. Phillips (Author/Creator)S.W. Worm (Author/Creator)R. Weber (Author/Creator)A. d’Arminio Monforte (Author/Creator)P. Reiss (Author/Creator)D. Kamara (Author/Creator)W. El-Sadr (Author/Creator)C. Pradier (Author/Creator)F. Dabis (Author/Creator)M. Law (Author/Creator)J. Lundgren (Author/Creator)D. Nolan (Author/Creator)
- Publication Details
- AIDS, Vol.27(17), pp.2735-2748
- Publisher
- Lippincott Williams & Wilkins Ltd.
- Identifiers
- 991005540946107891
- Copyright
- © 2013 Lippincott Williams & Wilkins, Inc.
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites
Metrics
52 Record Views
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.66 HIV
- 1.66.1372 HIV Comorbidities
- Web Of Science research areas
- Immunology
- Infectious Diseases
- Virology
- ESI research areas
- Immunology