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PERSISTENT HIV LOW-LEVEL VIREMIA AND CARDIOVASCULAR RISK
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from Jules: viral load >400 have increased risk for cardiovascular disease compared to undetectable or 50-400, no increased risk comparing undetectable vs 50-400, this study found
Reported by Jules Levin
EACS 2015 Oct 21-24 Barcelona, Spain - 15th European AIDS Conference
Silvia Costarelli1, Davide Bernasconi2, Giuseppe Lapadula1, Francesco Castelli 3,4 ,Salvatore Casari 4, Franco Maggiolo5, Antonella Grisolia5, Annalisa Saracino6, Gian Maria Baldin 7 ,Massimo Dipietro 8, Daniela Segala9, Chiara Fornabaio10 , Nicola Mazzini 11 and
Andrea Gori 1,2 for the Italian MASTER cohort
1 "San Gerardo" Hospital, Monza, Italy; 2 University of Milano-Bicocca, Milan, Italy; 3 University of Brescia, Brescia, Italy; 4 "Spedali Civili" Hospital, Brescia, Italy; 5"Papa Giovanni XXIII" Hospital, Bergamo, Italy; 6 University of Bari, Bari, Italy; 7 Cattolica University, Rome, Italy; 8 "Careggi" Hospital, Firenze, Italy; 9 University of Ferrara, Ferrara, Italy; 10 "Istituti Spitalieri" Hospital, Cremona, Italy; 11 MISI foundation Brescia, Italy
We compared:
1- patients with pLLV (HIVRNA between 50 and 400 copies/mL in at least two consecutive measures),
2- patients failed (HIVRNA>400 copies/ml in at least two consecutive measurements), and
3- patients who mantained undetectable HIVRNA.
We considered 2 endpoints:
1. time to first event among CVD, AIDS and death;
2. time to first event between CVD and death (ignoring AIDS).
The overall number of events (cardiovascular, AIDS and death respectively) was: 45, 57 and 93 in the first group; 18, 53, 37 in the second and 6, 5, 4 in the third.
Conclusion
Our results suggest that pLLV does not influence CVD. Moreover, in our setting, pLLV does not even influence AIDS or death. Further studies are needed to better understand the possible clinical and immunological consequences of pLLV.
"In the multivariate analysis, failed patients had a higher hazard rate for both endpoint 1 (hazard ratios: 2.15, 95%CI: 1.63-2.85) and endpoint 2 (hazard ratios: 1.5, 95%CI: 1.04-2.16) compared to suppressed patients, while pLLV patients did not showed significantly different hazard rates compared to patients with sustained undetectable HIV RNA (Table 2 and 3)."
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