TY - JOUR
T1 - Association between chronic Hepatitis C virus infection and myocardial infarction among people living with HIV in the United States
AU - Williams-Nguyen, Jessica
AU - Hawes, Stephen E.
AU - Nance, Robin M.
AU - Lindström, Sara
AU - Heckbert, Susan R.
AU - Nina Kim, H.
AU - Chris Mathews, W.
AU - Cachay, Edward R.
AU - Budoff, Matt
AU - Hurt, Christopher B.
AU - Hunt, Peter W.
AU - Geng, Elvin
AU - Moore, Richard D.
AU - Mugavero, Michael J.
AU - Peter, Inga
AU - Kitahata, Mari M.
AU - Saag, Michael S.
AU - Crane, Heidi M.
AU - Delaney, Joseph A.
N1 - Funding Information:
Author affiliations: Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington (Jessica Williams-Nguyen, Stephen E. Hawes, Sara Lindström, Susan R. Heckbert, Joseph A. Delaney); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington (Jessica Williams-Nguyen, Sara Lindström); Department of Medicine, School of Medicine, University of Washington, Seattle, Washington (Robin M. Nance, H. Nina Kim, Mari M. Kitahata, Heidi M. Crane); Center for AIDS Research, University of Washington, Seattle, Washington (H. Nina Kim, Mari M. Kitahata, Heidi M. Crane); Cardiovascular Health Research Unit, University of Washington, Seattle, Washington (Susan R. Heckbert, Joseph A. Delaney); Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California (W. Chris Mathews, Edward R. Cachay); Department of Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California (Matt Budoff); Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Christopher B. Hurt); Division of Experimental Medicine, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California (Peter W. Hunt, Elvin Geng); Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland (Richard D. Moore); Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (Richard D. Moore); Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Michael J. Mugavero, Michael S. Saag); and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York (Inga Peter). This work was supported by the National Institutes of Health (grants R24 AI067039 (CNICS), R24S AI067039 (CNICS MI supplement), R01 HL126538, R01HL125027, U01AA020793, P30 AI027757 (University of Washington Center for AIDS Research), P30AI117943 (Third Coast Center for AIDS Research), U01DA037702, and U01AA020793) and the American Heart Association (grant 16FTF31200010). Conflict of interest: none declared.
Publisher Copyright:
© The Author(s) 2019. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Hepatitis C virus (HCV) infection is common among people living with human immunodeficiency virus (PLWH). Extrahepatic manifestations of HCV, including myocardial infarction (MI), are a topic of active research. MI is classified into types, predominantly atheroembolic type 1 MI (T1MI) and supply-demand mismatch type 2 MI (T2MI). We examined the association between HCV and MI among patients in the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems, a US multicenter clinical cohort of PLWH. MIs were centrally adjudicated and categorized by type using the Third Universal Definition of Myocardial Infarction. We estimated the association between chronic HCV (RNA+) and time to MI while adjusting for demographic characteristics, cardiovascular risk factors, clinical characteristics, and history of injecting drug use. Among 23,407 PLWH aged ≥18 years, there were 336 T1MIs and 330 T2MIs during a median of 4.7 years of follow-up between 1998 and 2016. HCV was associated with a 46% greater risk of T2MI (adjusted hazard ratio (aHR) = 1.46, 95% confidence interval (CI): 1.09, 1.97) but not T1MI (aHR = 0.87, 95% CI: 0.58, 1.29). In an exploratory cause-specific analysis of T2MI, HCV was associated with a 2-fold greater risk of T2MI attributed to sepsis (aHR = 2.01, 95% CI: 1.25, 3.24). Extrahepatic manifestations of HCV in this high-risk population are an important area for continued research.
AB - Hepatitis C virus (HCV) infection is common among people living with human immunodeficiency virus (PLWH). Extrahepatic manifestations of HCV, including myocardial infarction (MI), are a topic of active research. MI is classified into types, predominantly atheroembolic type 1 MI (T1MI) and supply-demand mismatch type 2 MI (T2MI). We examined the association between HCV and MI among patients in the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems, a US multicenter clinical cohort of PLWH. MIs were centrally adjudicated and categorized by type using the Third Universal Definition of Myocardial Infarction. We estimated the association between chronic HCV (RNA+) and time to MI while adjusting for demographic characteristics, cardiovascular risk factors, clinical characteristics, and history of injecting drug use. Among 23,407 PLWH aged ≥18 years, there were 336 T1MIs and 330 T2MIs during a median of 4.7 years of follow-up between 1998 and 2016. HCV was associated with a 46% greater risk of T2MI (adjusted hazard ratio (aHR) = 1.46, 95% confidence interval (CI): 1.09, 1.97) but not T1MI (aHR = 0.87, 95% CI: 0.58, 1.29). In an exploratory cause-specific analysis of T2MI, HCV was associated with a 2-fold greater risk of T2MI attributed to sepsis (aHR = 2.01, 95% CI: 1.25, 3.24). Extrahepatic manifestations of HCV in this high-risk population are an important area for continued research.
KW - Chronic hepatitis C infection
KW - HIV
KW - HIV coinfection
KW - Hepatitis C virus
KW - Myocardial infarction
KW - People living with HIV
KW - Type 2 myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=85088493866&partnerID=8YFLogxK
U2 - 10.1093/aje/kwz236
DO - 10.1093/aje/kwz236
M3 - Article
C2 - 31712804
AN - SCOPUS:85088493866
SN - 0002-9262
VL - 189
SP - 554
EP - 563
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
IS - 6
ER -