Rxivist combines preprints from bioRxiv with data from Twitter to help you find the papers being discussed in your field. Currently indexing 62,303 bioRxiv papers from 276,577 authors.
Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States
Stephen E Hawes,
Robin M Nance,
Susan R Heckbert,
H Nina Kim,
W Chris Mathews,
Edward R Cachay,
Christopher B Hurt,
Peter W Hunt,
Richard D Moore,
Michael J Mugavero,
Mari M Kitahata,
Michael S Saag,
Heidi M Crane,
Joseph A A Delaney
Posted 26 Oct 2018
bioRxiv DOI: 10.1101/453860
Posted 26 Oct 2018
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.
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