Background: People living with HIV (PLWHIV) have a 2-fold higher risk of having a cardiovascular event than HIV-negative individuals.
Objectives: To estimate the pooled proportion of moderate-high cardiovascular risk in PLWHIV obtained through different scores. In addition, to establish the prevalence of dyslipidemia, smoking habit, diabetes and high blood pressure in the studies included.
Methods: A bibliographic search was conducted in MEDLINE from studies on cardiovascular risk assessment in PLWHVI that took place during the period of inception to July 2018. Eligibility criteria for inclusion were: cross-sectional or longitudinal studies in HIV-positive adults in which prevalence of moderate-high cardiovascular risk (or data to calculate it) was reported, and include at least one of the following cardiovascular risk scores: Framingham, ASCVD, D:A:D, Progetto Cuore, PROCAM, SCORE, Regicor, World Health Organization scores.
Results: Bibliographic search identified 278 studies. Finally, thirty-nine peer-reviewed publications were identified for a collective total of 13698 subjects. The pooled prevalence of moderate-high cardiovascular risk in PLWHIV obtained with nine different scores through random-effect modeling was 20.41% (95% CI: 16.77-24.31). The most prevalent concomitant cardiovascular risk factor was dyslipidemia (39.5%), smoking (33.0 %), high blood pressure (19.8%) and diabetes (7.24%).
Conclusions: Data obtained in this systematic review indicate that more than 1 in every five subjects with HIV had a moderate-high cardiovascular risk. In consequence, the burden of cardiovascular disease in PLWHIV represents a public health problem. There is an urgent need to develop strategies to prevent and detect cardiovascular risk assessment effectively in PLWHIV.