Contributions of HIV, hepatitis C virus, and traditional vascular risk factors to peripheral artery disease in women

• Type of Material: Article
• Authors: Emily Cedarbaum, University of California San Francisco; Yifei Ma, University of California San Francisco; Rebecca Scherzer, University of California San Francisco; Jennifer C. Price, University of California San Francisco; Adaora A. Adimora, University of North Carolina; Marcas Bamman, University of Alabama Birmingham; Mardge Cohen, Cook County Health & Hospital Systems; Margaret A. Fischl, University of Miami; Kunihiro Matsushita, Johns Hopkins University; Ighovwerha Ofotokun, Emory University; Michael Plankey, Georgetown University; Eric C. Seaberg, Johns Hopkins University; Michael T. Yin, Columbia University; Carl Grunfeld, University of California San Francisco; Shant Vartanian, University of California San Francisco; Anjali Sharma, Albert Einstein College of Medicine; Phyllis C. Tien, University of California San Francisco
• Language: English
• Date: 2019-11-01
• Publisher: LIPPINCOTT WILLIAMS & WILKINS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Wolters Kluwer Health, Inc.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/QAD.0000000000002319
• Title of Journal or Parent Work: AIDS
• Volume: 33
• Issue: 13
• Start Page: 2025
• End Page: 2033
• Grant/Funding Information: The study was also supported by the University of California San Francisco Liver Center [P30 DK026743], by the National Institute of Allergy and Infectious Diseases [K24 AI 108516 (PCT) and R01 AI 087176 (PCT), which was administered by the Northern California Institute for Research and Education and with resources of the Veterans Affairs Medical Center, San Francisco, CA], by the University of California, San Francisco-Gladstone Institute of Virology & Immunology Center for AIDS Research [P30-AI027763 (JCP)] and by an ACG Junior Faculty Development Award (JCP) from the American College of Gastroenterology.; WIHS (Principal Investigators): UAB-MS WIHS (Michael Saag, Mirjam-Colette Kempf, and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos and Anjali Sharma), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Seble Kassaye), U01-AI-034994; Miami WIHS (Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women’s HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Joel Milam), U01-HD-032632 (WIHS I - WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA) and UL1-TR000454 (Atlanta CTSA).
• Keywords: ankle-brachial index; ANKLE-BRACHIAL INDEX; Life Sciences & Biomedicine; POPULATION; INDIVIDUALS; ASSOCIATION; INFLAMMATION; Virology; PREVALENCE; Immunology; CARDIOVASCULAR-DISEASE; Science & Technology; peripheral arterial disease; EPIDEMIOLOGY; HIV; women; Infectious Diseases; hepatitis C; MORTALITY; INTERAGENCY HIV

Abstract

Objectives:HIV and hepatitis C virus (HCV) have been associated with cardiovascular disease (CVD), but it is unclear whether HIV and HCV are also associated with peripheral artery disease (PAD). We examined the association of HIV, HCV, and traditional CVD risk factors with PAD in the Women's Interagency HIV Study, a multicenter US cohort.Methods:In this cross-sectional study, ankle-brachial index was estimated using Doppler ultrasound and manual sphygmomanometer in 1899 participants aged more than 40 years with HIV/HCV coinfection, HCV or HIV monoinfection, or neither infection. Multivariable logistic regression was used to estimate the odds of PAD (ankle-brachial index ≤0.9) after controlling for demographic, behavioral, and CVD risk factors.Results:Over two-thirds were African-American, median age was 50 years, and PAD prevalence was 7.7% with little difference by infection status. After multivariable adjustment, neither HIV nor HCV infection was associated with greater odds of PAD. Factors associated with PAD included older age [adjusted odds ratio (aOR): 2.01 for age 61-70 vs. 40-50 years; 95% confidence interval (CI): 1.04, 3.87], Black race (aOR: 2.30; 95% CI: 1.15, 4.63), smoking (aOR: 1.27 per 10-pack-year increment; 95% CI: 1.09, 1.48), and higher SBP (aOR: 1.14 per 10 mmHg; 95% CI: 1.01, 1.28).Conclusion:The high PAD prevalence in this nationally representative cohort of women with or at risk for HIV is on par with general population studies in individuals a decade older than our study's median age. HIV and HCV infection are not associated with greater PAD risk relative to uninfected women with similar risk factors. Modifiable traditional CVD risk factors may be important early intervention targets in women with and at risk for HIV.