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Cardiovascular Risk Reduction in an Aging HIV-Infected Population: The Impact of HCV Co-Infection

降低老龄化 HIV 感染人群的心血管风险：HCV 合并感染的影响

基本信息

批准号：
10092888
负责人：
Virginia Athena Triant
金额：
$ 81.53万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-05-01 至 2024-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10092888
关键词：
Acquired Immunodeficiency Syndrome Acute myocardial infarction Adult Affect Age Aging Algorithms American Antiviral Agents Biometry Cardiovascular Diseases Caring Chronic Chronic Disease Clinical Collaborations Data Discipline Disease Outcome Early treatment Epidemiology Event Extrahepatic HIV HIV Infections HIV/HCV Hepatitis C Hepatitis C Therapy Hepatitis C co-infection Hepatitis C virus Individual Infection Inflammation Inflammatory International Knowledge Long-Term Care Methods Modeling North America Patients Performance Population Prevention strategy Public Health Research Design Risk Risk Assessment Risk Factors Risk Reduction Role Sample Size Testing Time Viral Load result adjudicate antiretroviral therapy barrier to care burden of illness cardiovascular disorder prevention cardiovascular disorder risk cardiovascular risk factor chronic infection clinical care clinically relevant co-infection cohort curative treatments effective therapy improved innovation multidisciplinary novel prediction algorithm prospective public health priorities response risk prediction risk prediction model risk stratification virology

项目摘要

PROJECT SUMMARY/ABSTRACT The proposed study will investigate how Hepatitis C virus (HCV) impacts cardiovascular disease (CVD) risk among individuals co-infected with HIV and HCV: Specific Aim 1. To quantify the impact of HCV co-infection on acute myocardial infarction (AMI) risk in a cohort of HIV-infected patients followed longitudinally in a large prospective clinical care cohort HIV infection increases CVD risk, and this risk is thought to be driven by non-traditional risk factors. Whether patients co-infected with HCV have further increased CVD risk and whether this interaction is influenced by age and HCV treatment status is not well understood. Importantly, CVD risk may persist even after treated HCV, and this question has not been previously answered. It is hypothesized that the presence of two chronic infections will increase risk beyond that of either infection alone. Specific Aim 2. To investigate whether treating HCV, and reducing its associated chronic inflammation, decreases risk of incident AMI The new era of HCV care has brought extremely effective treatment for HCV, yet access remains limited and barriers to treatment persist in co-infected patients. The extra-hepatic effects of HCV treatment – particularly direct-acting antivirals (DAAs) – are not known. With persistent barriers to HCV treatment, knowledge of whether HCV treatment can reduce CVD risk will have important public health implications for prioritizing patients for curative HCV treatment. Specific Aim 3. To assess the impact of HCV co-infection on CVD risk prediction in HIV Whether established CVD risk prediction algorithms provide an accurate assessment of risk in HIV/HCV co- infected patients remains unclear, particularly among co-infected patients. We propose to assess several established algorithms in a large cohort of co-infected patients. Through innovative analyses, we will incorporate HCV as a novel CVD risk factor into risk prediction functions to attempt to improve model performance in HIV. To complete the proposed aims and maximize the number of HIV/HCV co-infected individuals, we will leverage the largest collaboration of observational HIV cohorts in North America – the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). This is a uniquely well-suited cohort given its large sample size, adjudicated CVD events, and rigorously maintained data. Our multidisciplinary team includes internationally regarded epidemiology and biostatistics collaborators with expertise in methods of advanced causal inference and in CVD risk prediction modeling. This timely and clinically relevant study will advance the field by generating new knowledge on the impact of HCV on CVD risk and will directly impact the long-term care of aging HIV populations.

项目总结/文摘