Heart failure and adverse heart failure outcomes among persons living with HIV in a US tertiary medical center
American Heart Journal Jan 17, 2019
Alvi RM, et al. - In a cohort of 2,308 individuals admitted with decompensated heart failure (HF), researchers compared HF outcomes among persons living with Human Immunodeficiency Virus (HIV) [PLHIV] with HF [374 (16%)] vs individuals without HIV with HF. Comparisons were made with respect to baseline characteristics, 30-day HF readmission, cardiovascular (CV), and all-cause mortality. Within PLHIV, outcomes stratified between CD4 count, viral load (VL), were evaluated. They focused on 30-day HF readmission in relation to traditional and HIV-specific parameters. Among PLHIV, 92% subjects were on ART and 63% had a VL <200 copies/ml. As far as age, sex, race/ethnicity, and CV risk factors were concerned, these were found to be similar between the groups. They observed increased 30-day HF readmission (49 vs 32%), CV (26 vs 13.5%), and all-cause mortality rates (38 vs 22%) among PLHIV during follow-up. They noted that, 30-day HF readmission rate as well as CV and all-cause mortality was increased among PLHIV with a low CD4 count or detectable VL. In contrast, HF outcomes in PLHIV with a higher CD4 count and undetectable VL were similar to those seen in uninfected controls.
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