New Research Highlights Underestimated Heart Disease Risks in HIV Patients

Cardiovascular disease (CVD) remains the primary cause of illness and death worldwide, with individuals living with HIV facing heightened risk. A global study conducted by researchers from Massachusetts General Hospital and an international team has revealed that existing predictive models for assessing cardiovascular risk may not adequately serve this population.

The study, published in The Lancet HIV, evaluated the effectiveness of current atherosclerotic cardiovascular disease (ASCVD) risk scores among people living with HIV (PWH) from various economic backgrounds. The research utilized data from the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE), encompassing participants from low-, middle-, and high-income countries across multiple continents.

Findings indicate that the current risk models tend to underestimate the incidence of cardiovascular events in women and black men residing in high-income countries while overestimating risks for all PWH in low- and middle-income countries (LMICs). This discrepancy raises significant concerns about the adequacy of existing prediction tools for this specific population.

According to researchers, these results underscore the necessity for more nuanced and contextually relevant CVD prediction models tailored to the unique needs of individuals living with HIV, particularly in LMICs. The study emphasizes the importance of accurately identifying cardiovascular risks to improve treatment and prevention strategies.

Dr. Patrice Desvigne-Nickens, a medical officer at the National Heart, Lung, and Blood Institute, noted the importance of refining cardiovascular disease prediction models for this demographic. The study's comprehensive approach, which included diverse populations, allows for a more precise assessment of risk factors across different subgroups.

Co-lead author Dr. Steven Grinspoon highlighted the critical need for region-specific risk assessments that reflect the true cardiovascular risks faced by PWH. The team has calculated correction factors to address the underestimation observed in their findings, paving the way for future validation in external cohorts.

Dr. Markella Zanni, another co-lead author, expressed hope that the study's results will prompt guideline committees to consider enhanced treatment recommendations for women and black or African American men living with HIV in high-income settings. The ongoing development of accurate risk models is vital for improving healthcare outcomes for this vulnerable population.

For more detailed insights, refer to the publication titled Performance of the Pooled Cohorts Equations and D:A:D Risk Scores among Individuals with HIV in a Global Cardiovascular Disease Prevention Trial: A Cohort Study Leveraging Data from REPRIEVE, available in The Lancet HIV.