Traditional cardiovascular risk scores underestimate the incidence of cardiovascular diseases (CVD) in people living with HIV (PLH). This study compared the effect of HIV-specific cardiovascular risk factors (CRF) with traditional CRF at baseline for their association with incident CVD in PLH. The ongoing, prospective HIV HEART Aging (HIVH) study assesses CVD in PLH in the German Ruhr Area since 2004. PLH from the HIVH study with at least 5 years of follow-up were examined with the help of Cox proportional hazards models using inverse probability-of-censoring weights. The models were adjusted for age and sex. The obtained hazard ratios (HR) and 95% confidence limits (CL) assessed the strength of the associations between CRF and CVD. One thousand two hundred forty-three individuals (male 1,040, female 203; mean age of 43 ± 10 years) with 116 incident CVD events were analyzed. After adjusting for the traditional CRF, the HIV-specific CRF "a history of AIDS" and "higher age at diagnosis of HIV infection" (per 10 years) were associated with an increased CVD risk (HR 1.55, 95% CL: 1.05-2.28 and HR 1.55, 95% CL: 1.09-1.22, respectively). Higher CD4/CD8 ratio (per standard deviation), longer cumulative duration of antiretroviral therapies, and longer duration of HIV infection (per 10 years) showed indications for a decreased CVD risk (HR 0.75, 95% CL: 0.58-0.97, HR 0.71, 95% CL: 0.41-1.23, and HR 0.63, 95% CL: 0.44-0.90, respectively). Out of the traditional CRF, current smoking showed the strongest impact on CVD risk (HR 3.12, 95% CL: 2.06-4.74). In conclusion, HIV-specific factors, such as history of AIDS and CD4/CD8 ratio, were independently associated with an increased cardiovascular risk. Traditional CRF maintained a major effect on CVD. Clinical Trials Number (NCT04330287).

中文翻译：

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除艾滋病毒感染者的传统危险因素外，艾滋病毒特异性危险因素与心血管事件的关联。

传统的心血管风险评分低估了艾滋病毒感染者（PLH）心血管疾病（CVD）的发病率。本研究比较了 HIV 特异性心血管危险因素 (CRF) 与传统 CRF 在基线时的影响，以了解它们与 PLH 中 CVD 事件的关联。正在进行的前瞻性 HIV 心脏老化 (HIVH) 研究评估了自 2004 年以来德国鲁尔区 PLH 中的 CVD。通过使用逆概率的 Cox 比例风险模型，对经过至少 5 年随访的 HIVH 研究中的 PLH 进行了检查审查权重。模型根据年龄和性别进行了调整。获得的风险比 (HR) 和 95% 置信限 (CL) 评估了 CRF 和 CVD 之间关联的强度。对发生 116 起 CVD 事件的 1,243 人（男性 1,040 人，女性 203 人；平均年龄 43 ± 10 岁）进行了分析。对传统 CRF 进行调整后，HIV 特异性 CRF“艾滋病史”和“诊断 HIV 感染的较高年龄”（每 10 年）与 CVD 风险增加相关（HR 1.55，95% CL：1.05- 2.28 和 HR 1.55，95% CL：1.09-1.22，分别）。较高的 CD4/CD8 比率（每标准差）、较长的抗逆转录病毒治疗累计持续时间和较长的 HIV 感染持续时间（每 10 年）表明 CVD 风险降低（HR 0.75，95% CL：0.58-0.97，HR 0.71） ，95% CL：0.41-1.23，HR 0.63，95% CL：0.44-0.90）。在传统的 CRF 中，当前吸烟对 CVD 风险的影响最大（HR 3.12，95% CL：2.06-4.74）。总之，HIV 特异性因素，例如艾滋病史和 CD4/CD8 比率，与心血管风险增加独立相关。传统的 CRF 对 CVD 仍具有重大影响。临床试验编号 (NCT04330287)。