Hepatitis C is not significantly associated with the risk of myocarditis in HIV patients

The risk of developing myocarditis for HIV-infected patients is not necessarily associated with a Hepatitis C virus (HCV) is concomitant, but this risk increases with age.

A team led by Raynell Lang, MD, MSc, Department of Medicine, University of Calgary, determined whether HCV-associated infection increases the risk of type 1 myocardial infarction and whether the risk varies by age.

unknown danger

HIV-infected patients often have an elevated risk of developing cardiovascular disease, but the impact of hepatitis C co-infection is not yet understood. Some studies have found a 50-75% increased risk of cardiovascular disease in patients with HIV, compared to patients without HIV.

“The risk of cardiovascular disease among people with HCV infection alone is not consistent, with some studies showing increased risk and others showing no association,” the authors wrote. “Because of the shared routes of transmission, HIV/HCV co-infection is common (10%-30%) globally. Little is known about CVD risk among people with HCV, especially among the elderly. of the population receiving antiretroviral therapy (ART).

Data from North America

In the study, researchers used data from NA-ACCORD (North American AIDS Group Collaboration on Research and Design) from 2000-2017 for HIV-positive patients aged 40-79 years who started ART. NA-ACCORD is a collaboration of 29 clinical and interval groups from the United States, Canada, and the North American Region of International AIDS Assessment Epidemiology Databases.

The investigators sought the primary outcomes of a type 1 myocarditis event. Patients who started on HCV antiviral drugs at the time of initiation were censored.

The team then calculated the crude incidence rates per 1,000 person-years for type 1 myocardium chronologically. They also estimated adjusted hazard ratios and 95% confidence intervals (CIs) for type 1 myocarditis using discrete time analyzes with log-complementary models among and without HCV patients.

Comparing patients with and without viral hepatitis

Overall, 23361 patients were HIV positive, 20% (n = 4677) infected with HCV. There were 89 (1.9%) patients with type 1 myocarditis with HIV/HCV co-infection and 314 (1.7%) patients with HIV without HCV co-infection with co-infection. Cardiac muscle type I.

The results showed that hepatitis C was not associated with an increased risk of type 1 myocarditis in HIV-infected patients (aHR, 0.98; 95% CI, 0.74-1.30).

This risk also increased with age and was amplified in patients with viral hepatitis (aHR per 10-year increase in age, 1.85; 95% CI, 1.38–2.48) compared with patients without hepatitis C (aHR per 10). Increased years in life, 1.30; 95% CI, 1.13-1.50)s <.001, reaction test).

“Co-infection with hepatitis C virus was not significantly associated with the increase [type 1 myocarditis infarction] risk; However, the risk [type 1 myocarditis infarction] With age it was greater in those with hepatitis C virus than in those without hepatitis C, and hepatitis C status should be considered when assessing cardiovascular risk in old age. [people with HIV]The authors wrote.

the study, “Assessment of cardiovascular disease risk in elderly HIV-infected patients: impact of hepatitis C co-infection.“On the Internet at Journal of the American Heart Association.