4.6 Article

Estimated risk of cardiovascular disease among the HIV-positive patients aged 40 years or older in Taiwan

Journal

JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION
Volume 52, Issue 4, Pages 549-555

Publisher

ELSEVIER TAIWAN
DOI: 10.1016/j.jmii.2019.03.006

Keywords

Comorbidity; Framingham equation; Atherosclerotic cardiovascular disease (ASCVD); Data-collection on adverse effects of anti-HIV drugs (D:A:D); Antiretroviral therapy

Funding

  1. Centers for Disease Control, Taiwan [MOHW106-CDC-C-114-000107]

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Background: Cardiovascular disease (CVD) is an emerging cause of morbidity and mortality among HIV-positive patients receiving successful combination antiretroviral therapy, but their CVD risk has been rarely investigated in Asia-Pacific region. We aimed to assess the CVD risk of HIV-positive Taiwanese outpatients. Methods: We did cross-sectional questionnaire interviews to collect information of HIV-positive Taiwanese patients aged 40-79 at the HIV clinics of a medical center from 1 March to 31 August, 2017. The Framingham Risk Score (FRS), Atherosclerotic Cardiovascular Disease (ASCVD) risk score and Data-Collection on Adverse effects of Anti-HIV Drugs (D:A:D) risk score were used to estimate their CVD risk. Results: Of the screened 1251 patients, 1006 (80.4%) with complete data to assess their CVD risk were included for analyses. The prevalence of patients aged 40-75 and with a high CVD risk was 30.6% by FRS, 3.7% by D:A:D (R) risk score, and 22.2% by ASCVD risk score. In multiple logistic regression, older age, current smoking, higher systolic blood pressure, and higher triglyceride and fasting glucose levels were independently associated with the ASCVD risk score >= 7.5%. If current smokers aged 55-59 had stopped smoking, the proportions of them with a 10-year CVD risk of >= 10% by FRS and >= 7.5% by ASCVD risk score would have decreased by 35.3% and 20.0%, respectively. Conclusions: Higher CVD risk estimates among HIV-positive Taiwanese aged 40-75 were associated with an older age, current smoking, higher systolic blood pressure, hypertrigly-ceridemia, and hyperglycemia. Smoking cessation could potentially lead to significant decreases of CVD risk. Copyright (C) 2019, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.

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