HIV/HCV coinfection and the risk of cardiovascular disease: A meta‐analysis

• Published in: Journal of viral hepatitis Vol. 24; no. 11; pp. 998 - 1004
• Main Authors: Osibogun, O., Ogunmoroti, O., Michos, E. D., Spatz, E. S., Olubajo, B., Nasir, K., Madhivanan, P., Maziak, W.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-11-2017
• Subjects: Antiretroviral therapy; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cholesterol; Coinfection - complications; Congestive heart failure; Coronary artery; Coronary artery disease; Diabetes mellitus; Female; Health risk assessment; Hepacivirus; Hepatitis C; Hepatitis C - complications; Hepatitis C - virology; HIV; HIV Infections - complications; HIV Infections - virology; HIV/HCV coinfection; Human immunodeficiency virus; Humans; Inflammation; Life span; Low density lipoprotein; Male; Meta-analysis; metaanalysis; Proportional Hazards Models; Reviews; Risk; Risk factors; Smoking; Socioeconomic Factors; Statistical analysis; Stroke; cardiovascular disease; metaanalysis; HIV/HCV coinfection
• ISSN: 1352-0504; 1365-2893
• DOI: 10.1111/jvh.12725

Summary
The emergence of improved antiretroviral therapy has increased the life expectancy of human immunodeficiency virus (HIV)‐infected individuals, although there is an increased susceptibility to developing cardiovascular diseases (CVD). The risk for CVD is purported to be even higher among people with HIV and hepatitis C virus (HCV) coinfection because of the increased inflammatory response, which may synergistically impact CVD risk. However, studies comparing CVD outcomes between HIV alone and HIV/HCV individuals have been discordant. Accordingly, we conducted a meta‐analysis to clarify and quantify the association between HIV/HCV coinfection and the risk for CVD. We searched EMBASE, CINAHL, Google Scholar, PubMed, and Web of Science from inception to December 2016 to identify studies that provided information on HIV/HCV coinfection and CVD, defined as coronary artery disease, congestive heart failure and stroke. We used a random‐effects model to and pool data on the hazard ratios (HRs) for CVD. HRs were adjusted for traditional CVD risk factors including age, sex, smoking, hypertension, diabetes and LDL cholesterol. Among the 283 articles reviewed, four cohort studies met inclusion criteria with a total of 33 723 participants. The pooled adjusted HRs for the association between HIV/HCV coinfection and CVD were 1.24 (95% CI: 1.07‐1.40) compared to HIV monoinfection. The test for heterogeneity was not statistically significant (I2=0.0%, P=.397). In conclusion, individuals with HIV/HCV coinfection had an increased CVD risk compared to those with HIV monoinfection. More research is needed to further examine the nature of this association, and response to traditional risk‐reduction therapies.