The risk of incident coronary heart disease among veterans with and without HIV and hepatitis C.
The risk of incident coronary heart disease among veterans with and without HIV and hepatitis C.
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DOI：
10.1161/circoutcomes.110.957415
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发表时间：
2011-07
期刊：
影响因子：
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通讯作者：
Veterans Aging Cohort Study
中科院分区：
文献类型：
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作者：
Freiberg MS;Chang CC;Skanderson M;McGinnis K;Kuller LH;Kraemer KL;Rimland D;Goetz MB;Butt AA;Rodriguez Barradas MC;Gibert C;Leaf D;Brown ST;Samet J;Kazis L;Bryant K;Justice AC;Veterans Aging Cohort Study
Whether hepatitis C (HCV) confers additional coronary heart disease (CHD) risk among Human Immunodeficiency Virus (HIV) infected individuals is unclear. Without appropriate adjustment for antiretroviral therapy, CD4 count, and HIV-1 RNA, and substantially different mortality rates among those with and without HIV and HCV infection, the association between HIV, HCV, and CHD may be obscured. We analyzed data on 8579 participants (28% HIV+, 9% HIV+HCV+) from the Veterans Aging Cohort Study Virtual Cohort who participated in the 1999 Large Health Study of Veteran Enrollees. We analyzed data collected on HIV and HCV status, risk factors for and the incidence of CHD, and mortality from 1/2000–7/2007. We compared models to assess CHD risk when death was treated as a censoring event and as a competing risk. During the median 7.3 years of follow-up, there were 194 CHD events and 1186 deaths. Compared with HIV−HCV− Veterans, HIV+ HCV+ Veterans had a significantly higher risk of CHD regardless of whether death was adjusted for as a censoring event (adjusted hazard ratio (HR)=2.03, 95% CI=1.28–3.21) or a competing risk (adjusted HR=2.45, 95% CI=1.83–3.27 respectively). Compared with HIV+HCV− Veterans, HIV+ HCV+ Veterans also had a significantly higher adjusted risk of CHD regardless of whether death was treated as a censored event (adjusted HR=1.93, 95% CI=1.02–3.62) or a competing risk (adjusted HR =1.46, 95% CI=1.03–2.07). HIV+HCV+ Veterans have an increased risk of CHD compared to HIV+HCV−, and HIV−HCV− Veterans.
