Viremia Does Not Independently Predict Cardiovascular Disease in People With HIV: A RESPOND Cohort Study

作者：Olof Elvstam, Lene Ryom, Bastian Neesgaard, Luba Tau, Huldrych F. Günthard, Robert Zangerle, Jörg Janne Vehreschild, Ferdinand W.N.M. Wit, Anders Sönnerborg, Helen Kovari, Akaki Abutidze, Kathy Petoumenos, Nadine Jaschinski, Sean R Hosein, Johannes Bogner, Katharina Grabmeier‐Pfistershammer, H Garges, Jim Rooney, Lital Young, Matthew Law, Ole Kirk, for the RESPOND Study Group, F Wit, M van der Valk, M Hillebregt, K Petoumenos, M Law, Jolie Hutchinson, Dhanushi Rupasinghe, W Min Han, Robert Zangerle, H Appoyer, J Vera, Amanda Clarke, B Broster, L Barbour, D Carney, L Greenland, Robert J. Coughlan, Stéphane De Wit, M. Delforge, J Begovac, Gilles Wandeler, Carrie Stephan, M Bucht, Nikoloz Chkhartishvili, Otar Chokoshvili, Antonella d’Arminio Monforte, A Rodano, Alessandro Tavelli, C Mussini, Vanni Borghi, M Menozzi, A Cervo, C Pradier, E Fontas, K Dollet, C Caissotti, J Casabona, JM Miró, Josep M. Llibre, Antoni Riéra, Juliana Reyes‐Urueña, Fiona Burns, Christopher R. Smith, Fiona Lampe, C Chaloner, Antonella Castagna, Adriano Lazzarin, Andrea Poli, Riccardo Lolatto, A Sönnerborg, C Carlander, Piotr Nowak, Jan Vesterbacka, L.‐Å. Mattsson, D Carrick, K Stigsäter, Huldrych F. Günthard, B Ledergerber, H C Bucher, K Kusejko, J C Wasmuth, J Rockstroh, J J Vehreschild, Gerd Fätkenheuer, M Scherer, Georg Sauer, L Ryom, M Law, F Bognar, Rafael Del Campo, S De Wit, H Garges, Huldrych F. Günthard, C Mussini, J Lundgren, J Rooney, Vani Vannappagari, Gilles Wandeler, L Young, Robert Zangerle, J Lundgren, H Günthard, J Begovac, Fiona Burns, Antonella Castagna, Rafael Del Campo, Nikoloz Chkhartishvili, Antonella d’Arminio Monforte, N Dedes, Martin Dunbar, H Garges, J. Kowalska, Mark A. Law, C Mussini, Coca Necsoi, L Peters, K Petoumenos, C Pradier, David Raben, J Rockstroh, James F. Rooney, L Ryom, A Sönnerborg, V Vannappagari, Clara Lehmann, Alain Volny‐Anne, J C Wasmuth, E. D. Williams, F Wit, Lynn Young, Robert Zangerle, L Ryom, B Neesgaard, Lauren Greenberg, N Jaschinski, A Timiryasova, Loveleen Bansi‐Matharu, David Raben, L Peters, Erich Tusch, Wendy Bannister, Ashley Roen, D Byonanebye, O Fursa, Annegret Pelchen–Matthews, Joanne Reekie, V Svedhem-Johansson, Marc van der Valk, F Wit, Katharina Grabmeier‐Pfistershammer, Robert Zangerle, J Hoy, Mark Bloch, Dominique L. Braun, Alexandra Calmy, Gundolf Schüttfort, M Youle, S De Wit, C Mussini, Stefano Zona, Antonella Castagna, A Antinori, Nikoloz Chkhartishvili, N Bolokadze, E Fontas, K Dollet, C Pradier, JM Miró, Josep M. Llibre, J J Vehreschild, Carolynne Schwarze‐Zander, J C Wasmuth, J Rockstroh, K Petoumenos, Jolie Hutchinson, Mark A. Law, J Begovac, Claudine Duvivier, Gordana Dragović, Roxana Rădoi, C. Oprea, M Vasylyev, J. Kowalska, R Matulionyte, V Mulabdic, G Marchetti, Elena Kuzovatova, Nicola Coppola, Inka Aho, Salvatore Martini, H C Bucher, Arjan Harxhi, Torgun Wæhre, Anastasia Pharris, Anna Vassilenko, Gerd Fätkenheuer, Johannes R. Bogner, Anne Maagaard, Elżbieta Jabłonowska, Daniel Elbirt, Gaetano Marrone, Clifford Leen, Christoph Wyen, Line Dahlerup Rasmussen, C Hatleberg, C Carlander, M Kundro, Fiona Burns, Olof Elvstam, N Dedes, Emily D. Williams, Joel E. Gallant, CJ Cohen, Martin Dunbar, A Marongiu, Vani Vannappagari, H Garges, Rafael Del Campo, Lynn Young, Akaki Abutidze, Inka Aho, J Begovac, Line Dahlerup Rasmussen, Rafael Del Campo, Martin Dunbar, A. Ekström, Olof Elvstam, O Fursa, C Hatleberg, Joel E. Gallant, H Garges, Joshua Gruber, Huldrych F. Günthard, Jafari Rouhi Amir Hosein, J Hoy, Ole Kirk, M Law, Nadine Jaschinski, A Marongiu, Bastian Neesgaard, L Peters, K Petoumenos, J Rooney, Lene Ryom, A Sönnerborg, A Timiryasova, M Van der Valk, Vani Vannappagari, Jörg Janne Vehreschild, Anna Weibull Wärnberg, Ferdinand W.N.M. Wit, Xin Xu, L Young, Robert Zangerle, René Horsleben Petersen, Mark Bower, Kirstine Lærum Sibilitz, Alain Volny‐Anne, N Dedes, Luís Mendão, N Jaschinski, A Timiryasova, B Neesgaard, O Fursa, O Valdenmaier, M Gardizi, T W Elsing, Lalitesh Kumar, L Ryom, Jens Fromholt Larsen, David Raben, L Peters, Lauren Greenberg, K Petoumenos, W Min Han, Erich Tusch, Wendy Bannister, Joanne Reekie · 发表于：Open Forum Infectious Diseases · 年份：2025 · DOI：10.1093/ofid/ofaf016 · 被引用次数：4 · 研究领域：HIV-related health complications and treatments、HIV Research and Treatment、Hepatitis C virus research

Background: HIV viremia has been considered a cardiovascular disease (CVD) risk factor, but many studies have had insufficient data on potential confounders. We explored the association between viremia and CVD after adjusting for established risk factors and analyzed whether consideration of viremia would improve CVD prediction. Methods: Adults from RESPOND were followed from the first date with available data until the first of rigorously defined CVD, loss to follow-up, death, or administrative censoring. We first analyzed the associations between 6 measures of viremia (time-updated, before antiretroviral therapy [ART], viremia category, and measures of cumulative viremia) and CVD after adjusting for the variables in the D:A:D CVD score (age, sex/gender, smoking, family history, diabetes, recent abacavir, CD4 count, blood pressure, cholesterol, high-density lipoprotein, cumulative use of stavudine, didanosine, indinavir, lopinavir, and darunavir). We subsequently compared predictive performance with and without viremia in 5-fold internal cross-validation. Results: A total of 547 events were observed in 17 497 persons (median follow-up, 6.8 years). Although some viremia variables were associated with CVD in univariable analyses, there were no statistically significant associations after adjusting for potential confounders, neither for measures of current viral load, pre-ART viral load, highest viremia category during ART, nor cumulative viremia (modeled both as total cumulati...