Association Between Chronic Hepatitis C Virus Infection and Myocardial Infarction Among People Living With HIV in the United States. Issue 6 (12th November 2019)

• Record Type: Journal Article
• 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
• Is Part Of: American journal of epidemiology. Volume 189:Issue 6(2020)
• Page Start: 554
• Page End: 563
• Publication Date: 2019-11-12
• Subjects: chronic hepatitis C infection -- hepatitis C virus -- HIV -- HIV coinfection -- myocardial infarction -- people living with HIV -- type 2 myocardial infarction; Epidemiology -- Periodicals; Public health -- Periodicals; 614.4
• DOI: 10.1093/aje/kwz236
• Languages: English
• ISSNs: 0002-9262

Abstract

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.