A study assessed and compared the accuracy of cardiovascular risk scores among individuals with human immunodeficiency virus (HIV) compared with the general population. The researcher found that people living with HIV (PLWH) have a higher cardiovascular risk. The full findings were published in the European Journal of Preventative Cardiology.
In this study, the Systematic Coronary Risk Evaluation Score 2 (SCORE2), the Pooled Cohort Equations (PCE), and the HIV-specific Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) score were calculated in individuals (mean age, 40.6 years old) free from atherosclerotic cardiovascular disease (ASCVD) between 2003 and 2009. In total, the study analyzed 6,373 PLWH from the Swiss HIV Cohort Study (SHCS), and 5,403 individuals from the CoLaus|PsyCoLaus study. The team tested discrimination and calibration, and the value of adding HIV-specific factors to scores using the net reclassification improvement (NRI).
During mean follow-ups of 13.5 years in SHCS and 9.9 years in CoLaus|PsyCoLaus study, 8.4% and 6.9% of people developed an incident ASCVD, respectively. The findings translated into age-adjusted incidence rates of 12.9 and 7.5 per 1000 person-years, respectively. Accounting for HIV-specific variables (CD4 nadir and abacavir exposure) in SCORE2 and PCE resulted in an NRI of -0.1% (95% CI, -1.24 to 1, P = 0.83) and of 2.7% (95% CI, 0.3-5.1, P = 0.03), respectively.
“PLWH present a two-fold higher rate of incident ASCVD compared to individuals from the general population. SCORE2 and PCE, which are clinically easier to use (reduced set of variables without adding HIV-specific factors), are valid to predict ASCVD in PLWH,” the researchers concluded.
Keywords: Calibration, Cardiovascular, Discrimination, HIV, PLWH, Prevention, Risk score