HIV, Hepatitis C Coinfection Increases Cardiovascular Risk

The risk of myocardial infarction increases among individuals with hepatitis C virus (HCV) and HIV as they age, according to a recent study.

Given that people with HIV are at risk of cardiovascular disease (CVD) if infected with HCV that is left untreated, the researchers aimed to establish whether HCV coinfection increases the risk of myocardial infarction at different ages.

The researchers pulled data from the North American AIDS Collaboration on Research and Design (NA-ACCORD) spanning from January 1, 2000 to December 31, 2017. The cohort included people with HIV aged 40 to 79 years who had initiated antiretroviral therapy for the disease (n =  23,361).

Among the total, 4,677 (20%) individuals had HCV. Throughout a median follow-up of approximately 4 years, the researchers compared those with only HIV to those who were coinfected with HIV and HCV, examining the occurrence of myocardial infarction among the cohorts. The groups were examined as a whole and by each decade of age.

Based on the data, the researchers found that 89 (1.9%) patients who experienced a myocardial infarction also had HIV and HCV, and 324 (1.7%) with HIV, but not HCV, experienced a myocardial infarction.

The risk of myocardial infarction increased with each decade in patients diagnosed with HCV alone (adjusted hazard ratio per 10-year increase in age, 1.85 [95% CI, 1.38 – 2.48]) compared with patients without HCV (adjusted hazard ratio per 10-year increase in age, 1.30 [95% CI, 1.13 – 1.50]; P < 0.001, test of interaction). Additionally, with each increase in age, myocardial infarction increased 30% in people with HIV and 85% in people with HCV coinfection.

The researchers saw no association between HCV and an increased myocardial infarction risk in people with HIV (adjusted hazard ratio, 0.98 [95% CI, 0.74 – 1.30]).

“HCV coinfection was not significantly associated with increased [myocardial infarction] risk; however, the risk of [myocardial infarction] with increasing age was greater in those with HCV compared with those without, and HCV status should be considered when assessing CVD risk in aging PWH,” the researchers concluded.

—Jessica Ganga

Reference:

Lang R, Humes E, Hogan B, et al. Evaluating the cardiovascular risk in an aging population of people with HIV: the impact of hepatitis C virus coinfection. J Am Heart Assoc. Published online September 21, 2022. doi: 10.1161/JAHA.122.026473