XIX International AIDS Conference

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Prevalence of cardiovascular risk factors in Spanish HIV-positive patients on antiretroviral therapy. The CORONATOR Study

V. Estrada1, J.I. Bernardino de la Serna2, J.L. Casado3, P. Domingo4, M. Masia5, J.A. Iribarren6, F. Lozano7, A. Rodriguez da Silva8, J. Olalla9, J. Santos10

1Hospital Clinico San Carlos, Madrid, Spain, 2Hospital La Paz, Madrid, Spain, 3Hospital Ramon y Cajal, Madrid, Spain, 4Hospital Santa Creu i Sant Pau, Barcelona, Spain, 5Hospital General Universitario de Elche, Elche, Spain, 6Hospital Donostia, San Sebastián, Spain, 7Hospital Universitario Virgen de Valme, Sevilla, Spain, 8CHUVI-Xeral, Vigo, Spain, 9Hospital Costa del Sol, Marbella, Spain, 10Hospital Virgen de la Victoria, Málaga, Spain

Background: Cardiovascular risk is a topic of increasing concern in the setting of HIV infection. Our study aimed to estimate the risk of cardiovascular disease (CVD) in a representative sample of the population of HIV patients who receive antiretroviral therapy in Spain.
Methods: Cross-sectional analysis within 10 HIV units across Spain. We collected data on demographics, HIV disease status and treatment history as well as cardiovascular risk factors. Cardiovascular risk estimation was made by Regicor score (Framingham score adapted to Spain). This analysis describes the prevalence of cardiovascular risk factors in our population.
Results: There were 895 subjects included, 100% on antiretroviral therapy with a median time since HIV diagnosis of 11 years and median time on ART of 8 years. Median age was 46 y, 76.4% were male. Current median CD4 count (IQR) was 597 c/mm3 (402-791) and 88% of the patients had HIV RNA< 50 cop/mL. 35 subjects (3.9%) reported a history of previous CVD. Table 1 shows the prevalence of cardiovascular risk factors in our population.

 Total n=895
Age (men > 55 y, women > 65 y) n(%)94 (10.5)
Cigarette smoking, n(%)481 (54.0)
Hypertension, n(%)280 (31.4)
Diabetes, n(%)67 (7.6)
Total cholesterol > 240 mg/mL, n(%)92 (10.5)
HDL-cholesterol < 40 mg/mL, n(%)291 (33.3)
Total/HDL cholesterol ratio >5, n(%)235 (26.9)
LDL-cholesterol > 160 mg/mL71 (8.2)
Triglycerides > 200 mg/mL191 (21.7)
[Table 1]

Other known risk factors include family history of early CVD in 173 (20.0%) subjects, physical inactivity in 452 (59.8%) and metabolic syndrome in 172 (19.6%). Renal function impairment (EPI4_CKD < 60 ml/min/1.73 m2) was present in 41 subjects (4.7%). For those subjects with no history of CVD (n=860), median value of Framingham-Regicor Score (IQR) was 3% (2-4). The percentage of patients showing a moderate to high 10 years cardiovascular risk (>5%) was 22.2%.
Conclusions: We found a high prevalence of traditional cardiovascular risk factors in this population of Spanish patients with HIV infection. It seems advisable a more aggressive management of modifiable CVD risk factors to prevent the occurrence of cardiovascular disease in these patients.

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