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- Title
Association Between Chronic Hepatitis C Virus Infection and Myocardial Infarction Among People Living With HIV in the United States.
- Authors
Williams-Nguyen, Jessica; Hawes, Stephen E; Nance, Robin M; Lindström, Sara; Heckbert, Susan R; Kim, H Nina; Mathews, W Chris; Cachay, Edward R; Budoff, Matt; Hurt, Christopher B; Hunt, Peter W; Geng, Elvin; Moore, Richard D; Mugavero, Michael J; Peter, Inga; Kitahata, Mari M; Saag, Michael S; Crane, Heidi M; Delaney, Joseph A
- Abstract
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.
- Subjects
UNITED States; MYOCARDIAL infarction risk factors; HIV-positive persons; INTRAVENOUS drug abuse; CARDIOVASCULAR diseases risk factors; CONFIDENCE intervals; HEPATITIS C; MYOCARDIAL infarction; RISK assessment; SEPSIS; TIME; DESCRIPTIVE statistics; DISEASE complications
- Publication
American Journal of Epidemiology, 2020, Vol 189, Issue 6, p554
- ISSN
0002-9262
- Publication type
Article
- DOI
10.1093/aje/kwz236