Cardiovascular risk prediction models in people living with human immunodeficiency virus under antiretroviral therapy in northern mexico

Arguiñe I. Urraza-Robledo, Unidad Médica de Alta Especialidad # 71, Instituto Mexicano del Seguro Social, Torreón, Coah., Mexico
Francisco C. López-Márquez, Department of Molecular Immunobiology, Centro de Investigación Biomédica, Torreón, Coah., Mexico
Faviel F. González-Galarza, Department of Molecular Immunobiology, Centro de Investigación Biomédica, Torreón, Coah., Mexico
Domingo Pere-Pedrol, Infectous Diseases Unit, Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
María E. Gutiérrez-Pérez, Department of Molecular Immunobiology, Centro de Investigación Biomédica, Torreón, Coah., Mexico
Ana P. Roiz-Bollain y Goytia, Department of Neonatology, Hospital Ignacio Morones Prieto San Luis Potosí, San Luis Potosí, Mexico
Pablo Ruiz-Flores, Departament of Genetics, Centro de Investigación Biomédica, Torreón, Coah., Mexico
Fanny K. Segura-López, Unidad Médica de Alta Especialidad # 71, Instituto Mexicano del Seguro Social, Torreón, Coah., Mexico
Alberto A. Miranda-Pérez, Department of Molecular Immunobiology, Centro de Investigación Biomédica, Torreón, Coah., Mexico

Background: The effective use of combination antiretroviral therapy (ART) has significantly improved the life expectancy of people living with the human immunodeficiency virus (HIV). However, complications have shifted from opportunistic infections to issues such as drug toxicity and resistance, as well as an increase in premature cardiovascular diseases (CVD). These conditions are attributed to chronic immune activation and persistent inflammation caused by HIV, along with lipid abnormalities and insulin resistance. Objective: The objective of the study was to predict cardiovascular risk at 5 and 10 years in people living with HIV with combination ART using three algorithmic models. Methods: This study included 186 HIV-seropositive patients under treatment. The variables analyzed included anthropometric measurements, family history of hypertension and CVDs, years of infection, years of treatment, and treatment scheme. We used three well-established algorithmic models for assessing cardiovascular risk: Framingham (10-year period), Data Collection on Adverse Events of Anti-HIV Drugs Study (D: A: D) reduced, and full (5-year period). Results: Approximately 65% of the study participants were undergoing a treatment regimen comprising two nucleoside reverse transcriptase inhibitors (NRTIs) combined with a non-NRTIs. The mean body mass index analysis indicated that 28.5% of the participants were overweight and 17.7% obese. In addition, 53.8% of the patients exhibited hypertriglyceridemia, and 54.8% met the diagnostic criteria for metabolic syndrome. The D: A: D reduced and full models identified significant risk factors for individuals over 30 years of age, highlighting notable associations with cholesterol levels, triglyceride levels, and smoking status. In contrast, the Framingham model did not demonstrate significant risk associations.

Keywords: Human immunodeficiency virus. Cardiovascular risk. Overweight. Metabolic syndrome. Antiretroviral therapy.