New study provides insights into cardiovascular disease risk among people living with HIV

Medical concept of a human body with an artery showing microscopic pathogen and red cells at risk of disease coming from the cardiovascular system

A sub-study of the international REPRIEVE clinical trial found that approximately half of study participants, who were considered by traditional measures to be at low-to-moderate risk of future heart disease, had atherosclerotic plaque in their arteries.

The REPRIEVE clinical trial focuses on heart disease prevention in people living with HIV, and recruited participants with low to moderate atherosclerotic cardiovascular disease pooled cohort equation, or ASCVD PCE, risk scores and a low average 10-year risk score of 4.5 percent.

And the sub-study was designed to specifically identify factors that contribute to cardiovascular disease among people living with HIV. The study appeared in the Journal of the American Medical Association Network Open.

The sub-study described baseline data on 755 participants between 40 and 75 years of age who were enrolled at 31 sites across the United States. Researchers used coronary CT angiography to assess the amount of plaque in participants’ coronary arteries. They then correlated those findings with blood samples that measured inflammation and immune activation.

Nearly half of the participants had plaque mostly seen in a few areas of their coronary arteries. The presence of plaque was associated with a higher burden of risk factors, but also with higher levels of inflammation independent of traditional risk scores. Almost all individuals had plaque buildup that did not narrow more than 50 percent of their coronary arteries. While significant narrowing was rare, about one-quarter of participants had plaque with features that could cause problems in the future. The study was partly funded by NHLBI.