Title:Cardiovascular Risk Assessment in People Living With HIV: A Systematic Review and Meta-Analysis of Real-Life Data
VOLUME: 18 ISSUE: 1
Author(s):Marina Grand*, Daniel Bia and Alejandro Diaz
Affiliation:Instituto de Investigacion en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Pringles 4375, Olavarría (7400), Departamento de Fisiologia, Facultad de Medicina, Universidad de la Republica, Centro Universitario de Investigacion, Innovacion y Diagnostico Arterial (CUiiDARTE), Universidad de la Republica General Flores 2125, PC 11800 Montevideo, Instituto de Investigacion en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Pringles 4375, Olavarría (7400)
Keywords:Cardiovascular risk, risk assessment, human immunodeficiency virus, systematic review, meta-analysis, PLWHIV.
Abstract:
Background: People living with HIV (PLWHIV) have a 2-fold higher risk of having a
cardiovascular event than HIV-negative individuals.
Objective: The objective of this article is to estimate the pooled proportion of moderate-high cardiovascular
risk in PLWHIV obtained through different scores. In addition, this study also aims to establish
the prevalence of dyslipidemia, smoking habits, diabetes and high blood pressure in the included
studies.
Methods: A bibliographic search was conducted in MEDLINE for studies on cardiovascular risk assessment
in PLWHVI that took place during the period of inception to July 2018. The eligibility criteria
for inclusion were: cross-sectional or longitudinal studies on HIV-positive adults in which the
prevalence of moderate-high cardiovascular risk (or data to calculate it) was reported, and included
at least one of the following cardiovascular risk scores: Framingham, ASCVD, D:A:D, Progetto
Cuore, PROCAM, SCORE, Regicor, and 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%).
Conclusion: Data obtained in this systematic review indicate that more than 1 in every five subjects
with HIV have 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 effectively in PLWHIV.
