Trends in the risk of myocardial infarction among HIV-1-infected individuals relative to the general population in France: Impact of gender and immune status

Creators: Baldé, Aliou; Lang, Sylvie; Wagner, Aline; Ferrières, Jean; Montaye, Michele; Tattevin, Pierre; Cotte, Laurent; Aslangul, Élisabeth; Bidegain, Frédéric; Chéret, Antoine; Mary-Krause, Murielle; Meynard, Jean-Luc; Molina, Jean-Michel; Partisani, Marialuisa; Roger, Pierre-Marie; Boccara, Franck; Costagliola, Dominique

Others:: Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU); Université de Strasbourg (UNISTRA); CHU Toulouse [Toulouse]; Institut Pasteur de Lille ; Réseau International des Instituts Pasteur (RIIP); Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes] ; CHU Pontchaillou [Rennes]; Hôpital Pontchaillou; Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL) ; Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Hospices Civils de Lyon (HCL); Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL] ; Hôpital de la Croix-Rousse [CHU - HCL] ; Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL); Université Paris Descartes - Paris 5 (UPD5); Service de médecine interne [HU Hotêl-Dieu] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu [Paris] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Université Sorbonne Paris Cité (USPC); Service des maladies infectieuses et tropicales ; Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Hôpital Avicenne [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine] ; CHU Saint-Antoine [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU); Service de maladies infectieuses et tropicales [Saint-Louis] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Génétique et immunologie des maladies parasitaires (GIMP) ; Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Le Trait d'Union, centre de soins de l'infection par le VIH [CHU Strasbourg] ; CHU Strasbourg; Université Nice Sophia Antipolis (1965 - 2019) (UNS) ; COMUE Université Côte d'Azur (2015-2019) (COMUE UCA); Hôpital l'Archet; Service de Cardiologie [CHU Saint-Antoine] ; CHU Saint-Antoine [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Description

We examined trends in the MI incidence and age at MI diagnosis among adults living with HIV-1 between 2000 and 2009, by comparison with the French MI registries, by gender. Age standardized incidence rates and standardized incidence-ratios (SIRs) were estimated for individuals included in the French hospital database on HIV (n = 71 204, MI = 663) during three periods: 2000-2002, 2003-2005 and 2006-2009. Median ages at MI diagnosis were compared using the Brown-Mood test. Over the study periods, the absolute rate difference and relative risks were higher in women than in men in 2000-2002 and 2006-2009, with respective SIRs 1.99 (1.39-2.75) and 1.12 (0.99-1.27) in 2006-2009. The trends were different for men and women with a decreasing trend in SIRs in men and no change in women. In both sexes, among individuals with CD4 ≥500/μL and controlled viral-load on cART, the risk was no longer elevated. Age at MI diagnosis was significantly younger than in the general population, especially among women (-6.2 years, p<0.001; men: -2.1 years, p = 0.02). In HIV-1-positive adults, absolute rate difference and relative risks and trends of MI were different between men and women and there was no additional risk among individuals on effective cART.

Abstract

International audience

Trends in the risk of myocardial infarction among HIV-1-infected individuals relative to the general population in France: Impact of gender and immune status

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