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Douglas PS, Umbleja T, Bloomfield GS, et al. Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial. Clin Infect Dis. 2021;73(11):2009-2022doi: 10.1093/cid/ciab552.
Douglas, P. S., Umbleja, T., Bloomfield, G. S., Fichtenbaum, C. J., Zanni, M. V., Overton, E. T., Fitch, K. V., Kileel, E. M., Aberg, J. A., Currier, J., Sponseller, C. A., Melbourne, K., Avihingsanon, A., Bustorff, F., Estrada, V., Ruxrungtham, K., Saumoy, M., Navar, A. M., Hoffmann, U., Ribaudo, H. J., & Grinspoon, S. (2021). Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 73(11), 2009-2022. https://doi.org/10.1093/cid/ciab552
Douglas, Pamela S, et al. "Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial." Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 73,11 (2021): 2009-2022. doi: https://doi.org/10.1093/cid/ciab552
Douglas PS, Umbleja T, Bloomfield GS, Fichtenbaum CJ, Zanni MV, Overton ET, Fitch KV, Kileel EM, Aberg JA, Currier J, Sponseller CA, Melbourne K, Avihingsanon A, Bustorff F, Estrada V, Ruxrungtham K, Saumoy M, Navar AM, Hoffmann U, Ribaudo HJ, Grinspoon S. Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial. Clin Infect Dis. 2021 Dec 06;73(11):2009-2022. doi: 10.1093/cid/ciab552. PMID: 34134131; PMCID: PMC8664454.
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Clin Infect Dis. 2021 Dec 06;73(11):2009-2022. doi: 10.1093/cid/ciab552.

Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Pamela S Douglas, Triin Umbleja, Gerald S Bloomfield, Carl J Fichtenbaum, Markella V Zanni, Edgar T Overton, Kathleen V Fitch, Emma M Kileel, Judith A Aberg, Judith Currier, Craig A Sponseller, Kathleen Melbourne, Anchalee Avihingsanon, Flavio Bustorff, Vicente Estrada, Kiat Ruxrungtham, Maria Saumoy, Ann Marie Navar, Udo Hoffmann, Heather J Ribaudo, Steven Grinspoon

Affiliations

  1. Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.
  2. Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
  3. University of Cincinnati, Cincinnati, Ohio, USA.
  4. Massachusetts General Hospital, Boston, Massachusetts, USA.
  5. University of Alabama at Birmingham, Birmingham, Alabama, USA.
  6. Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  7. University of California at Los Angeles, Los Angeles, California, USA.
  8. Kowa Pharmaceuticals America, Inc., Montgomery, Alabama, USA.
  9. Gilead Sciences, Inc., Foster City, California, USA.
  10. HIV Netherlands Australia Thailand Research Collaboration, Thai Red Cross AIDS Research Centre, and Tuberculosis Research Unit, Faculty of Medicine, Chulalongkorn University, Thailand.
  11. Hospital Geral de Nova Iguacu, Rio de Janeiro,Brazil.
  12. Hospital San Carlos, Madrid, Spain.
  13. Hospital de Bellvitge, l'Hospitalet de Llobregat, Spain.
  14. University of Texas Southwestern Medical Center, Dallas, Texas, USA.

PMID: 34134131 PMCID: PMC8664454 DOI: 10.1093/cid/ciab552

Abstract

BACKGROUND: In addition to traditional cardiovascular (CV) risk factors, antiretroviral therapy, lifestyle, and human immunodeficiency virus (HIV)-related factors may contribute to future CV events in persons with HIV (PWH).

METHODS: Among participants in the global REPRIEVE randomized trial, we characterized demographics and HIV characteristics relative to ACC/AHA pooled cohort equations (PCE) for atherosclerotic CV disease predicted risk and CV health evaluated by Life's Simple 7 (LS7; includes smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and glucose).

RESULTS: Among 7382 REPRIEVE participants (31% women, 45% Black), the median PCE risk score was 4.5% (lower and upper quartiles Q1, Q3: 2.2, 7.2); 29% had a PCE score <2.5%, and 9% scored above 10%. PCE score was related closely to known CV risk factors and modestly (<1% difference in risk score) to immune function and HIV parameters. The median LS7 score was 9 (Q1, Q3: 7, 10) of a possible 14. Only 24 participants (0.3%) had 7/7 ideal components, and 36% had ≤2 ideal components; 90% had <5 ideal components. The distribution of LS7 did not vary by age or natal sex, although ideal health was more common in low sociodemographic index countries and among Asians. Poor dietary and physical activity patterns on LS7 were seen across all PCE scores, including the lowest risk categories.

CONCLUSIONS: Poor CV health by LS7 was common among REPRIEVE participants, regardless of PCE. This suggests a critical and independent role for lifestyle interventions in conjunction with conventional treatment to improve CV outcomes in PWH. Clinical Trials Registration: NCT02344290. AIDS Clinical Trials Group study number: A5332.

© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.

Keywords: atherosclerotic cardiovascular disease; cardiac prevention; cardiovascular health; cardiovascular risk; lifestyle modifications

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