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Cardiovascular risk assessment in people living with HIV compared to the general population

Delabays, Benoît
Cavassini, Matthias
Damas, Jose
Beuret, Hadrien
Hasse, Barbara
Bucher, Heiner C
Frischknecht, Manuel
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Published in European journal of preventive cardiology. 2022, vol. 29, no. 4, p. 689-699

Aims: We prospectively assessed and compared the accuracy of cardiovascular risk scores in people living with HIV (PLWH) and individuals from the general population.

Methods and results: The Systematic Coronary Risk Evaluation Score 2 (SCORE2), the Pooled Cohort Equations (PCE), and the HIV-specific Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) score were calculated in participants free from atherosclerotic cardiovascular disease (ASCVD) between 2003 and 2009. In total, 6373 [mean age, 40.6 years (SD, 9.9)] PLWH from the Swiss HIV Cohort Study (SHCS) and 5403 [52.8 years (SD, 10.7)] individuals from the CoLaus|PsyCoLaus study were eligible for analysis. We tested discrimination and calibration, and the value of adding HIV-specific factors to scores using the net reclassification improvement (NRI). During mean follow-ups of 13.5 (SD, 4.1) in SHCS and 9.9 (SD, 2.3) years in CoLaus|PsyCoLaus study, 533 (8.4%) and 374 (6.9%) people developed an incident ASCVD, respectively. This translated into age-adjusted incidence rates of 12.9 and 7.5 per 1000 person-year, respectively. In SHCS, SCORE2, PCE, and D:A:D presented comparable discriminative capacities [area under the receiver operating characteristic curve of 0.745 (95% confidence interval, CI, 0.723-0.767), 0.757 (95% CI, 0.736-0.777), and 0.763 (95% CI, 0.743-0.783)]. Adding HIV-specific variables (CD4 nadir and abacavir exposure) to SCORE2 and PCE resulted in an NRI of-0.1% (95% CI,-1.24 to 1, P = 0.83) and of 2.7% (95% CI, 0.3-5.1, P = 0.03), respectively.

Conclusions: PLWH present a two-fold higher rate of incident ASCVD compared to individuals from the general population. SCORE2 and PCE, which are clinically easier to use (reduced set of variables without adding HIV-specific factors), are valid to predict ASCVD in PLWH.

Keywords: Calibration; Cardiovascular; Discrimination; HIV; PLWH; Prevention; Risk score.

Keywords CalibrationCardiovascularDiscriminationHIVPLWHPreventionRisk score
PMID: 34893801
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Research group VIH/SIDA (930)
SNSF: 33CSCO-122661
SNSF: 33CS30-139468
SNSF: 33CS30-148401
Swiss National Science Foundation: 32003B_173092
SNSF: 33CS30-177535/1
SNSF: #177499
(ISO format)
DELABAYS, Benoît et al. Cardiovascular risk assessment in people living with HIV compared to the general population. In: European journal of preventive cardiology, 2022, vol. 29, n° 4, p. 689-699. doi: 10.1093/eurjpc/zwab201 https://archive-ouverte.unige.ch/unige:162282

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Deposited on : 2022-07-27

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