Low CD4+ T Cell Count Is a Risk Factor for Cardiovascular Disease Events in the HIV Outpatient Study
Low CD4+ T Cell Count Is a Risk Factor for Cardiovascular Disease Events in the HIV Outpatient Study
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DOI：
10.1086/655144
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发表时间：
2010-08-15
影响因子：
11.8
通讯作者：
Brooks, John T.
中科院分区：
文献类型：
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作者：
Lichtenstein, Kenneth A.;Armon, Carl;Brooks, John T.
背景资料。传统的心血管疾病(CVD)危险因素、人类免疫缺陷病毒(HIV)感染和抗逆转录病毒(ARV)药物与HIV感染患者的CVD事件有关。我们调查了在美国10家HIV专科诊所接受治疗的一组门诊患者中，低CD4(+)T淋巴细胞计数与心血管事件的关系。我们研究了从2002年1月1日(基线)开始接受观察的患者，根据国家胆固醇教育计划指南将他们分为10年心血管风险评分(10-y CVR)组，并观察他们，直到心血管事件、死亡、最后一次HIV门诊研究接触，或2009年9月30日。我们使用COX比例风险模型计算了心血管事件的发生率并确定了相关的基线风险因素。我们还进行了一项嵌套式病例对照研究，以检查最新的CD4(+)细胞计数与心血管事件的相关性。在2005名患者中，148人经历了突发心血管事件。从最低的10年CVR组到最高的10年CVR组，心血管疾病的发病率从每100人年0.4次事件稳步增加到3.0次/100人年(P
Background. Traditional cardiovascular disease (CVD) risk factors, human immunodeficiency virus (HIV) infection, and antiretroviral (ARV) agents have been associated with CVD events in HIV-infected patients. We investigated the association of low CD4(+) T lymphocyte cell count with incident CVD in a cohort of outpatients treated in 10 HIV specialty clinics in the United States.Methods. We studied patients who were under observation from 1 January 2002 (baseline), categorized them according to National Cholesterol Education Program guidelines into 10-year cardiovascular risk score (10-y CVR) groups, and observed them until CVD event, death, last HIV Outpatient Study contact, or 30 September 2009. We calculated rates of incident CVD events and identified associated baseline risk factors using Cox proportional hazard models. We also performed a nested case-control study to examine the association of latest CD4(+) cell count with CVD events.Results. Among 2005 patients, 148 experienced incident CVD events. CVD incidence increased steadily from 0.4 to 3.0 events per 100 person-years from lowest to highest 10-y CVR group (P