Global Burden of Atherosclerotic Cardiovascular Disease in People Living With HIV

作者：Anoop Shah, Dominik Stelzle, Kuan Ken Lee, Eduard J. Beck, Shirjel Alam, Sarah Clifford, Chris T. Longenecker, Fiona E. Strachan, Shashwatee Bagchi, William Whiteley, Sanjay Rajagopalan, Shyamasundaran Kottilil, Harish Nair, David E. Newby, David McAllister, Nicholas L. Mills · 发表于：Circulation · 年份：2018 · DOI：10.1161/circulationaha.117.033369 · 被引用次数：994 · 研究领域：HIV-related health complications and treatments、Diabetes, Cardiovascular Risks, and Lipoproteins、Lipoproteins and Cardiovascular Health

BACKGROUND: With advances in antiretroviral therapy, most deaths in people with HIV are now attributable to noncommunicable illnesses, especially cardiovascular disease. We determine the association between HIV and cardiovascular disease, and estimate the national, regional, and global burden of cardiovascular disease attributable to HIV. METHODS: We conducted a systematic review across 5 databases from inception to August 2016 for longitudinal studies of cardiovascular disease in HIV infection. A random-effects meta-analysis across 80 studies was used to derive the pooled rate and risk of cardiovascular disease in people living with HIV. We then estimated the temporal changes in the population-attributable fraction and disability-adjusted life-years (DALYs) from HIV-associated cardiovascular disease from 1990 to 2015 at a regional and global level. National cardiovascular DALYs associated with HIV for 2015 were derived for 154 of the 193 United Nations member states. The main outcome measure was the pooled estimate of the rate and risk of cardiovascular disease in people living with HIV and the national, regional, and global estimates of DALYs from cardiovascular disease associated with HIV. RESULTS: In 793 635 people living with HIV and a total follow-up of 3.5 million person-years, the crude rate of cardiovascular disease was 61.8 (95% CI, 45.8-83.4) per 10 000 person-years. In comparison with individuals without HIV, the risk ratio for cardiovascular disease was 2.16 (95%...