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Associations between HIV viremia during antiretroviral therapy and cardiovascular disease
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Elvstam, O. (författare)
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Marrone, G. (författare)
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Engstrom, G. (författare)
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Nilsson, P. M. (författare)
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Carlander, C. (författare)
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Treutiger, C. J. (författare)
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- Gisslén, Magnus, 1962 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
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Bjorkman, P. (författare)
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(creator_code:org_t)
- 2022-06-22
- 2022
- Engelska.
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Ingår i: Aids. - : Ovid Technologies (Wolters Kluwer Health). - 0269-9370 .- 1473-5571. ; 36:13, s. 1829-1834
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective: To investigate the association between HIV viremia exposure during antiretroviral therapy (ART) and cardiovascular disease (CVD) risk. Design: Nationwide observational cohort. Methods: Participants (age >15 years) from the Swedish nationwide InfCareHIV register initiating ART 1996-2017 were categorized in a time-updated manner into four viremia categories, starting from 12 months after ART initiation: suppression (<50 copies/ml), low-level viremia (50-199 copies/ml and 200-999 copies/ml, respectively), and high-level viremia (>= 1000 copies/ml). In addition, cumulative viremia was estimated as the area under the log viral load (VL) curve. Proportional subhazard models adjusted for sex, age, pre-ART CD4 and VL, injection drug use, and country of birth were used to analyze the association between viremia exposure and CVD risk (ischemic heart disease, stroke, and heart failure; data obtained by linkage to national registers), accounting for the competing risk of non-CVD death. Results: In all, 337 cases of CVD were observed during 44 937 person-years of follow-up (n = 6562). Higher viremia exposure was associated with CVD, both when parameterized as cumulative viremia (adjusted subhazard ratio [aSHR] per 1 log(10) copy x year/ml, 1.03; 95% confidence interval [CI], 1.01-1.05) and as viremia category (aSHR for high-level viremia versus suppression, 1.45; 95% CI, 1.03-2.05). We observed no association between CVD and low-level viremia compared with those with suppression. Conclusions: Higher exposure to HIV viremia was linked to CVD in ART recipients, whereas no increased risk was detected for people with low-level viremia compared with viral suppression. Causal inference is limited by the observational nature of this study.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Nyckelord
- cardiovascular diseases
- HIV infections
- epidemiology
- myocardial
- ischemia
- stroke
- viremia
- low-level viremia
- infected patients
- myocardial-infarction
- viral load
- mortality
- people
- care
- predictor
- risk
- progression
- Immunology
- Infectious Diseases
- Virology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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