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Arterioscler Thromb Vasc Biol. 2016 Oct;36(10):2100-7. doi: 10.1161/ATVBAHA.116.307985. Epub 2016 Sep 8.

HIV, Cocaine Use, and Hepatitis C Virus: A Triad of Nontraditional Risk Factors for Subclinical Cardiovascular Disease.

Author information

1
From the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (G.M.L., M.G.A., D.M.F., M.M.E., K.Z.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.M.M.); and Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S.). glucas@jhmi.edu.
2
From the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (G.M.L., M.G.A., D.M.F., M.M.E., K.Z.); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (A.M.M.); and Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (J.H.S.).

Abstract

OBJECTIVE:

We assessed cross-sectional and longitudinal associations of 3 nontraditional cardiovascular disease risk factors-HIV, cocaine use, and chronic hepatitis C virus infection-with 3 validated markers of subclinical cardiovascular disease: carotid artery plaque, albuminuria, and aortic pulse wave velocity in a well-characterized cohort.

APPROACH AND RESULTS:

We measured carotid plaque at baseline and after 24 months, urine albumin/creatinine ratio every 6 months, and pulse wave velocity annually for up to 36 months in a predominantly black cohort of 292 participants (100 HIV negative and 192 HIV positive). Thirty-nine percent had chronic hepatitis C virus infection and 20%, 28%, and 52% were never, past, and current cocaine users, respectively. Sixteen percent, 47%, and 64% of those with none, 1 or 2, or all 3 nontraditional risk factors had ≥2 abnormal cardiovascular disease risk markers (P=0.001). In fully adjusted models that included all 3 nontraditional risk factors, HIV infection was independently associated with carotid plaque progression (increase in the number of anatomic segments with plaque), albuminuria (albumin-creatinine ratio >30 mg/g), albuminuria progression (doubling of albumin-creatinine ratio from baseline to a value >30 mg/g), and pulse wave velocity. Cocaine use was associated with an ≈3-fold higher odds of carotid plaque at baseline, and hepatitis C virus infection was significantly associated with a higher risk of carotid plaque progression.

CONCLUSIONS:

These results suggest that HIV infection, cocaine use, and hepatitis C virus infection are important nontraditional risk factors for cardiovascular disease and highlight the need to understand the distinct and overlapping mechanisms of the associations.

KEYWORDS:

HIV infections; cocaine; kidney; pulse wave analysis; ultrasonography

PMID:
27609369
PMCID:
PMC5033718
DOI:
10.1161/ATVBAHA.116.307985
[Indexed for MEDLINE]
Free PMC Article

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