Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States

Williams-Nguyen, J.; Hawes, S. E.; Nance, R. M.; Lindström, S.; Heckbert, S. R.; Kim, H. N.; Mathews, W. C.; Cachay, E. R.; Budoff, M. J.; Hurt, C. B.; Hunt, P. W.; Geng, E.; Moore, R. D.; Mugavero, M. J.; Peter, I.; Kitahata, M. M.; Saag, M. S.; Crane, H. M.; Delaney, J. A. A.

doi:10.1101/453860

bioRxiv · 10.1101/453860

Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States

Williams-Nguyen, J.·Hawes, S. E.·Nance, R. M.·Lindström, S.·Heckbert, S. R.·Kim, H. N.·Mathews, W. C.·Cachay, E. R.·Budoff, M. J.·Hurt, C. B.·Hunt, P. W.·Geng, E.·Moore, R. D.·Mugavero, M. J.·Peter, I.·Kitahata, M. M.·Saag, M. S.·Crane, H. M.·Delaney, J. A. A.

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Abstract

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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Williams-Nguyen, J., Hawes, S. E., Nance, R. M., Lindström, S., Heckbert, S. R., Kim, H. N., Mathews, W. C., Cachay, E. R., Budoff, M. J., Hurt, C. B., Hunt, P. W., Geng, E., Moore, R. D., Mugavero, M. J., Peter, I., Kitahata, M. M., Saag, M. S., Crane, H. M., Delaney, J. A. A.. 2018-10-26. Association between chronic hepatitis C virus infection and myocardial infarction in people living with HIV in the United States. https://doi.org/10.1101/453860

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