Background: Of myocardial infarctions (MIs) recorded in 2 large human immunodeficiency virus (HIV) observational studies from North America, approximately half were classified as type 2. In the REPRIEVE clinical trial of pitavastatin versus placebo in people with HIV (PWH) (<3% of participants were from Europe), 20.6% of MIs were type 2. The proportions of type 1 MI (T1MI) and type 2 MI (T2MI) in European PWH are unknown.

Methods: The study included a retrospective record review, ascertainment of prospectively recorded and medically validated MIs, differentiation of T1MI and T2MI, and MI time trend analysis in the Swiss HIV Cohort Study (1 January 2000 to 31 May 2021). Exploratory analysis was performed of the associations of T1MI and T2MI with blood leukocyte count and 2 validated genome-wide coronary artery disease-associated polygenic risk scores (metaGRS and GPS_mult ).

Results: Between 2000 and 2021, 16 027 Swiss HIV Cohort Study participants accumulated 181 598 years of follow-up, and 379 had a validated first MI. Of these participants, 359 (94.7%) had T1MI, and 20 (5.3%) had T2MI. Invasive coronary angiography was done in 95% and 60% of participants with T1MI and T2MI, respectively. We found no evidence for increasing or decreasing incidence trends over time for T1MI (P = .86) or T2MI (P = .85). Participants in the highest quintile for leukocyte count, metaGRS, and GPS_mult had significantly increased adjusted odds ratios for T1MI; power was limited for detecting associations with T2MI.

Conclusions: The proportion of T2MI in PWH in Switzerland is approximately 5%, consistent with data from the general population and lower than in previous North American reports among PWH.