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Associations between immune depression and cardiovascular events in HIV infection

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Associations between immune depression and cardiovascular events in HIV infection. / Sabin, Caroline A; Ryom, Lene; De Wit, Stephane; Mocroft, Amanda; Phillips, Andrew N; Worm, Signe W; Weber, Rainer; D'Arminio Monforte, Antonella; Reiss, Peter; Kamara, David; El-Sadr, Wafaa; Pradier, Christian; Dabis, Francois; Law, Matthew; Lundgren, Jens; D:A:D study Group.

In: AIDS, Vol. 27, No. 17, 13.11.2013, p. 2735-48.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Sabin, CA, Ryom, L, De Wit, S, Mocroft, A, Phillips, AN, Worm, SW, Weber, R, D'Arminio Monforte, A, Reiss, P, Kamara, D, El-Sadr, W, Pradier, C, Dabis, F, Law, M, Lundgren, J & D:A:D study Group 2013, 'Associations between immune depression and cardiovascular events in HIV infection', AIDS, vol. 27, no. 17, pp. 2735-48. https://doi.org/10.1097/01.aids.0000432457.91228.f3

APA

Sabin, C. A., Ryom, L., De Wit, S., Mocroft, A., Phillips, A. N., Worm, S. W., Weber, R., D'Arminio Monforte, A., Reiss, P., Kamara, D., El-Sadr, W., Pradier, C., Dabis, F., Law, M., Lundgren, J., & D:A:D study Group (2013). Associations between immune depression and cardiovascular events in HIV infection. AIDS, 27(17), 2735-48. https://doi.org/10.1097/01.aids.0000432457.91228.f3

Vancouver

Sabin CA, Ryom L, De Wit S, Mocroft A, Phillips AN, Worm SW et al. Associations between immune depression and cardiovascular events in HIV infection. AIDS. 2013 Nov 13;27(17):2735-48. https://doi.org/10.1097/01.aids.0000432457.91228.f3

Bibtex

@article{b81ead2c9fde42ce8f65ef50735e9892,
title = "Associations between immune depression and cardiovascular events in HIV infection",
abstract = "OBJECTIVE: To consider associations between the latest/nadir CD4 cell count, and time spent with CD4 cell count less than 200 cells/μl (duration of immune depression), and myocardial infarction (MI), coronary heart disease (CHD), stroke, or cardiovascular disease (CVD) (CHD or stroke) in 33 301 HIV-positive individuals.DESIGN: Longitudinal cohort study.METHODS: Analyses were undertaken using Poisson regression. To investigate whether analyses of stroke were robust to the type of endpoint, we additionally included stroke-like events and rejected strokes into the stroke endpoint.RESULTS: Participants experienced 716 MI, 1056 CHD, 303 stroke, and 1284 CVD events. Whereas there was no evidence of a higher MI/CHD risk in those with lower latest/nadir CD4 cell counts after adjustment [current CD4 <100 cells/μl: relative rate (95% confidence interval) 0.96 (0.62-1.50) for MI, 0.89 (0.30-2.36) for CHD; nadir CD4 <100 cells/μl: 1.36 (0.57-3.23) for MI, 0.98 (0.45-2.16) for CHD], stroke and CVD rates were higher in those with a latest CD4 cell count less than 100 cells/μl [2.26 (1.29-3.94) and 1.14 (0.84-1.56), respectively]. All events occurred less frequently in those who had not experienced immune depression, although evidence for a linear association with duration of immune depression was weak. The association between stroke risk and the latest CD4 cell count strengthened as stroke-like and rejected strokes were included; conversely, associations with established stroke risk factors weakened.CONCLUSION: We do not find strong evidence that HIV-positive individuals with a low CD4 cell count are more likely to experience MI/CHD. Although strokes appear to occur more commonly at low CD4 cell counts, this may be partly explained by misclassification or other biases.",
author = "Sabin, {Caroline A} and Lene Ryom and {De Wit}, Stephane and Amanda Mocroft and Phillips, {Andrew N} and Worm, {Signe W} and Rainer Weber and {D'Arminio Monforte}, Antonella and Peter Reiss and David Kamara and Wafaa El-Sadr and Christian Pradier and Francois Dabis and Matthew Law and Jens Lundgren and {D:A:D study Group} and {van Lunzen}, Jan",
year = "2013",
month = nov,
day = "13",
doi = "10.1097/01.aids.0000432457.91228.f3",
language = "English",
volume = "27",
pages = "2735--48",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "17",

}

RIS

TY - JOUR

T1 - Associations between immune depression and cardiovascular events in HIV infection

AU - Sabin, Caroline A

AU - Ryom, Lene

AU - De Wit, Stephane

AU - Mocroft, Amanda

AU - Phillips, Andrew N

AU - Worm, Signe W

AU - Weber, Rainer

AU - D'Arminio Monforte, Antonella

AU - Reiss, Peter

AU - Kamara, David

AU - El-Sadr, Wafaa

AU - Pradier, Christian

AU - Dabis, Francois

AU - Law, Matthew

AU - Lundgren, Jens

AU - D:A:D study Group

AU - van Lunzen, Jan

PY - 2013/11/13

Y1 - 2013/11/13

N2 - OBJECTIVE: To consider associations between the latest/nadir CD4 cell count, and time spent with CD4 cell count less than 200 cells/μl (duration of immune depression), and myocardial infarction (MI), coronary heart disease (CHD), stroke, or cardiovascular disease (CVD) (CHD or stroke) in 33 301 HIV-positive individuals.DESIGN: Longitudinal cohort study.METHODS: Analyses were undertaken using Poisson regression. To investigate whether analyses of stroke were robust to the type of endpoint, we additionally included stroke-like events and rejected strokes into the stroke endpoint.RESULTS: Participants experienced 716 MI, 1056 CHD, 303 stroke, and 1284 CVD events. Whereas there was no evidence of a higher MI/CHD risk in those with lower latest/nadir CD4 cell counts after adjustment [current CD4 <100 cells/μl: relative rate (95% confidence interval) 0.96 (0.62-1.50) for MI, 0.89 (0.30-2.36) for CHD; nadir CD4 <100 cells/μl: 1.36 (0.57-3.23) for MI, 0.98 (0.45-2.16) for CHD], stroke and CVD rates were higher in those with a latest CD4 cell count less than 100 cells/μl [2.26 (1.29-3.94) and 1.14 (0.84-1.56), respectively]. All events occurred less frequently in those who had not experienced immune depression, although evidence for a linear association with duration of immune depression was weak. The association between stroke risk and the latest CD4 cell count strengthened as stroke-like and rejected strokes were included; conversely, associations with established stroke risk factors weakened.CONCLUSION: We do not find strong evidence that HIV-positive individuals with a low CD4 cell count are more likely to experience MI/CHD. Although strokes appear to occur more commonly at low CD4 cell counts, this may be partly explained by misclassification or other biases.

AB - OBJECTIVE: To consider associations between the latest/nadir CD4 cell count, and time spent with CD4 cell count less than 200 cells/μl (duration of immune depression), and myocardial infarction (MI), coronary heart disease (CHD), stroke, or cardiovascular disease (CVD) (CHD or stroke) in 33 301 HIV-positive individuals.DESIGN: Longitudinal cohort study.METHODS: Analyses were undertaken using Poisson regression. To investigate whether analyses of stroke were robust to the type of endpoint, we additionally included stroke-like events and rejected strokes into the stroke endpoint.RESULTS: Participants experienced 716 MI, 1056 CHD, 303 stroke, and 1284 CVD events. Whereas there was no evidence of a higher MI/CHD risk in those with lower latest/nadir CD4 cell counts after adjustment [current CD4 <100 cells/μl: relative rate (95% confidence interval) 0.96 (0.62-1.50) for MI, 0.89 (0.30-2.36) for CHD; nadir CD4 <100 cells/μl: 1.36 (0.57-3.23) for MI, 0.98 (0.45-2.16) for CHD], stroke and CVD rates were higher in those with a latest CD4 cell count less than 100 cells/μl [2.26 (1.29-3.94) and 1.14 (0.84-1.56), respectively]. All events occurred less frequently in those who had not experienced immune depression, although evidence for a linear association with duration of immune depression was weak. The association between stroke risk and the latest CD4 cell count strengthened as stroke-like and rejected strokes were included; conversely, associations with established stroke risk factors weakened.CONCLUSION: We do not find strong evidence that HIV-positive individuals with a low CD4 cell count are more likely to experience MI/CHD. Although strokes appear to occur more commonly at low CD4 cell counts, this may be partly explained by misclassification or other biases.

U2 - 10.1097/01.aids.0000432457.91228.f3

DO - 10.1097/01.aids.0000432457.91228.f3

M3 - SCORING: Journal article

C2 - 23842128

VL - 27

SP - 2735

EP - 2748

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 17

ER -