Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Viremia Does Not Independently Predict Cardiovascular Disease in People With HIV : A RESPOND Cohort Study

Elvstam, Olof LU orcid ; Ryom, Lene ; Neesgaard, Bastian ; Tau, Luba ; Günthard, Huldrych F ; Zangerle, Robert ; Vehreschild, Jörg Janne ; Wit, Ferdinand ; Sönnerborg, Anders and Kovari, Helen , et al. (2025) In Open Forum Infectious Diseases 12(2).
Abstract

BACKGROUND: HIV viremia has been considered a cardiovascular disease (CVD) risk factor, but many studies have had insufficient data on potential confounders. We explored the association between viremia and CVD after adjusting for established risk factors and analyzed whether consideration of viremia would improve CVD prediction.

METHODS: Adults from RESPOND were followed from the first date with available data until the first of rigorously defined CVD, loss to follow-up, death, or administrative censoring. We first analyzed the associations between 6 measures of viremia (time-updated, before antiretroviral therapy [ART], viremia category, and measures of cumulative viremia) and CVD after adjusting for the variables in the D:A:D... (More)

BACKGROUND: HIV viremia has been considered a cardiovascular disease (CVD) risk factor, but many studies have had insufficient data on potential confounders. We explored the association between viremia and CVD after adjusting for established risk factors and analyzed whether consideration of viremia would improve CVD prediction.

METHODS: Adults from RESPOND were followed from the first date with available data until the first of rigorously defined CVD, loss to follow-up, death, or administrative censoring. We first analyzed the associations between 6 measures of viremia (time-updated, before antiretroviral therapy [ART], viremia category, and measures of cumulative viremia) and CVD after adjusting for the variables in the D:A:D CVD score (age, sex/gender, smoking, family history, diabetes, recent abacavir, CD4 count, blood pressure, cholesterol, high-density lipoprotein, cumulative use of stavudine, didanosine, indinavir, lopinavir, and darunavir). We subsequently compared predictive performance with and without viremia in 5-fold internal cross-validation.

RESULTS: A total of 547 events were observed in 17 497 persons (median follow-up, 6.8 years). Although some viremia variables were associated with CVD in univariable analyses, there were no statistically significant associations after adjusting for potential confounders, neither for measures of current viral load, pre-ART viral load, highest viremia category during ART, nor cumulative viremia (modeled both as total cumulative viremia, cumulative viremia during ART, and recent cumulative viremia). Consistently, none of the viremia variables improved prediction capacity.

CONCLUSIONS: In this large international cohort, HIV viremia was not associated with CVD when adjusting for established risk factors. Our results did not show viremia to be predictive of CVD among people with HIV.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Open Forum Infectious Diseases
volume
12
issue
2
article number
ofaf016
publisher
Oxford University Press
external identifiers
  • scopus:85216938337
  • pmid:39896984
ISSN
2328-8957
DOI
10.1093/ofid/ofaf016
language
English
LU publication?
yes
additional info
© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
id
aa311e1b-c940-4195-8d51-9cd47b1fe250
date added to LUP
2025-02-04 13:56:50
date last changed
2025-07-02 16:31:57
@article{aa311e1b-c940-4195-8d51-9cd47b1fe250,
  abstract     = {{<p>BACKGROUND: HIV viremia has been considered a cardiovascular disease (CVD) risk factor, but many studies have had insufficient data on potential confounders. We explored the association between viremia and CVD after adjusting for established risk factors and analyzed whether consideration of viremia would improve CVD prediction.</p><p>METHODS: Adults from RESPOND were followed from the first date with available data until the first of rigorously defined CVD, loss to follow-up, death, or administrative censoring. We first analyzed the associations between 6 measures of viremia (time-updated, before antiretroviral therapy [ART], viremia category, and measures of cumulative viremia) and CVD after adjusting for the variables in the D:A:D CVD score (age, sex/gender, smoking, family history, diabetes, recent abacavir, CD4 count, blood pressure, cholesterol, high-density lipoprotein, cumulative use of stavudine, didanosine, indinavir, lopinavir, and darunavir). We subsequently compared predictive performance with and without viremia in 5-fold internal cross-validation.</p><p>RESULTS: A total of 547 events were observed in 17 497 persons (median follow-up, 6.8 years). Although some viremia variables were associated with CVD in univariable analyses, there were no statistically significant associations after adjusting for potential confounders, neither for measures of current viral load, pre-ART viral load, highest viremia category during ART, nor cumulative viremia (modeled both as total cumulative viremia, cumulative viremia during ART, and recent cumulative viremia). Consistently, none of the viremia variables improved prediction capacity.</p><p>CONCLUSIONS: In this large international cohort, HIV viremia was not associated with CVD when adjusting for established risk factors. Our results did not show viremia to be predictive of CVD among people with HIV.</p>}},
  author       = {{Elvstam, Olof and Ryom, Lene and Neesgaard, Bastian and Tau, Luba and Günthard, Huldrych F and Zangerle, Robert and Vehreschild, Jörg Janne and Wit, Ferdinand and Sönnerborg, Anders and Kovari, Helen and Abutidze, Akaki and Petoumenos, Kathy and Jaschinski, Nadine and Hosein, Sean and Bogner, Johannes and Grabmeier-Pfistershammer, Katharina and Garges, Harmony and Rooney, Jim and Young, Lital and Law, Matthew and Kirk, Ole}},
  issn         = {{2328-8957}},
  language     = {{eng}},
  number       = {{2}},
  publisher    = {{Oxford University Press}},
  series       = {{Open Forum Infectious Diseases}},
  title        = {{Viremia Does Not Independently Predict Cardiovascular Disease in People With HIV : A RESPOND Cohort Study}},
  url          = {{http://dx.doi.org/10.1093/ofid/ofaf016}},
  doi          = {{10.1093/ofid/ofaf016}},
  volume       = {{12}},
  year         = {{2025}},
}