Background and importance Cardiovascular disease (CVD) is a major cause of morbidity and mortality in HIV patients. Recent studies suggest that the increased incidence of CVD is due to increased patient longevity, chronic inflammation and immune activation associated with HIV infection and antiretroviral therapy (ART) itself, which may contribute to increased cardiovascular risk (CVR).
Aim and objectives To establish the frequency of cardiovascular risk factors (CVRF), as well as to estimate the incidence of CVR in patients with HIV.
Material and methods Observational, retrospective study with all HIV patients with ART who were followed up by the Infectious Diseases Unit during 2020 at the Outpatient Unit.
The role of the hospital pharmacist in the treatment of these patients is the prevention, identification and management of the side effects associated with ART.
The variables gathered were: age, gender, AIDS prevalence, time since diagnosis, time and current ART.
The CVRF were evaluated following the criteria of the European Society of Cardiology: age, male gender, smoking, hypertension, diabetes, dyslipidaemia, obesity.
The Framingham scale adapted to the HIV population was used to determine the risk of CVD at 10 years: low risk (<5%), moderate (5–10%), high (10–15%) or very high (≥15%) of myocardial infarction or coronary death.
Results 950 HIV patients were included (73% male, mean age 52 years). Most of the patients had long-term infection, 25% with AIDS criteria and on ART for an average of 14 years. 98% were receiving ART, 16% with non-nucleoside analogues, 40% with protease inhibitors and 47% with transcriptase inhibitors.
The prevalence of CVRF was: age >45 years 78.5%, smoking 44%, hypertension 26.3%, diabetes 18.1%, HDL-cholesterol (HDL-C <35 mg/dL) 16.1%, total cholesterol (C-total >240 mg/dL) 10.8% and obesity 15.1%. There was a higher prevalence of CVRF associated with the male gender, which was statistically significant in diabetes, lower HDL-C and higher triglycerides (p<0.05).
Regarding the CVR assessment by the Framingham scale, the mean was 10.6% (95% CI 9.9% to 11.1%). CVR was significantly higher in men than in women (12.21% vs 6.25%, p<0.001).
Conclusion and relevance Classic CVRF are very common in patients with HIV, which carries a high risk of CVD. Therefore, it is advisable to improve the primary control of modifiable CVRF in HIV patients and to assess the use of drugs with a better CVR profile.
Conflict of interest No conflict of interest
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