WEDNESDAY, Sept. 8, 2021 (HealthDay News) — People living with HIV (PLWH) have an increased risk for sudden cardiac death (SCD), with an even higher risk seen for those with elevated HIV viral load or low CD4 cell counts, according to a study published online Sept. 8 in the Journal of the American Heart Association.

Matthew S. Freiberg, M.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues examined participants from the Veterans Aging Cohort Study, including veterans with and without HIV infection matched for age, sex, race/ethnicity, and clinical site. The potential associations for HIV infection, CD4 cell counts, and/or HIV viral load with World Health Organization-defined SCD risk were examined. Data were included for 144,336 participants (mean baseline age, 50.0 years), 30 percent of whom were PLWH.

During a median follow-up of 9.0 years, there were 3,035 SCDs. The researchers found that after adjustment for possible confounders, HIV infection was associated with increased SCD risk (hazard ratio [HR], 1.14; 95 percent confidence interval [CI], 1.04 to 1.25). Compared with veterans without HIV, PLWH with CD4 counts <200 cells/mm3 or viral load >500 copies/mL had an increased risk for SCD (HRs [95 percent CIs], 1.57 [1.28 to 1.92] and 1.70 [1.46 to 1.98], respectively) in analyses with time-varying CD4 and HIV viral load. No increased risks were seen for PLWH with CD4 counts >500 cells/mm3 or HIV viral load <500 copies/mL (HR, 0.97; 95 percent CI, 0.87 to 1.09).

“Our data suggest that treating HIV infection and the associated risk factors for SCD could reduce SCD risk among PLWH,” the authors write.

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