Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States

Jessica Williams-Nguyen, Stephen E. Hawes, Robin M. Nance, Sara Lindström, Susan R. Heckbert, H. Nina Kim, W. Chris Mathews, Edward R. Cachay, Matt Budoff, Christopher B. Hurt, Peter W. Hunt, Elvin Geng, Richard D. Moore, Michael J. Mugavero, Inga Peter, Mari M. Kitahata, Michael S. Saag, Heidi M. Crane, Joseph A. Delaney

Research output: Contribution to journalArticlepeer-review

Abstract

Hepatitis C virus (HCV) is common among people living with HIV (PLWH). The potential for extrahepatic manifestations of HCV, including myocardial infarction (MI), is 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 in the CFAR Network of Integrated Clinical Systems (CNICS), a multi-center clinical cohort of PLWH. MIs were centrally adjudicated and categorized by type using the Universal MI definition. We estimated the association between chronic HCV (RNA+) and time to MI adjusting for demographic characteristics, cardiovascular risk factors, clinical characteristics and substance use. Among 24,755 PLWH aged ≥18, there were 336 T1MI and 330 T2MI during a median of 4.2 years of follow-up. HCV was associated with a 68% greater risk of T2MI (adjusted hazard ratio (aHR) 1.68, 95% CI: 1.22, 2.30) but not T1MI (aHR 0.96, 95% CI: 0.63, 1.45). In a cause-specific analysis of T2MI, HCV was associated with a 2-fold greater risk of T2MI attributed to sepsis (aHR 2.26, 95% CI: 1.34, 3.81). Extrahepatic manifestations of HCV in this high-risk population are an important area for continued research.

Original languageEnglish (US)
JournalUnknown Journal
DOIs
StatePublished - Oct 26 2018
Externally publishedYes

Keywords

  • hepatitis C virus (HCV)
  • human immunodeficiency virus (HIV)
  • myocardial infarction
  • people living with HIV (PLWH)
  • Type 2 myocardial infarction

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • Immunology and Microbiology(all)
  • Neuroscience(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)

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