A large study in Spain finds that COVID-19 is associated with a 30% increased risk of major cardiovascular events in people with HIV during the year following infection. The study is published in Clinical Microbiology and Infection.
Using a population of people in Catalonia with HIV (PWH) who had a documented COVID-19 infection, plus PWH with no COVID infections, the authors of the study estimated the incidence rate (IR) of a first cardiovascular event (CVE) after COVID-19 during an average follow-up period of 243 days.
Included were 4,199 PWH with and 14,004 PWH without COVID-19 infections, 82% of all study subjects were men, and the average age was 47. Overall, 211 PWH with COVID-19 and 621 without developed CVE, the authors said, with an IR of 70.2 and 56.8 per 1,000 person-years, respectively.
Even mild infections pose risk
COVID-19 was associated with a 30% increased subsequent risk of CVE (adjusted hazard ratio, 1.30; 95% confidence interval, 1.09 to 1.55). Risk was highest in the 6 months following acute infection, and there was no association with COVID-19 severity and subsequent CVE, suggesting that even mild to moderate infections increased the risk.
"Even while the absolute rates of CVE in PWH have significantly declined in recent years, they continue to have a 1.5-2-fold greater relative risk compared to individuals without HIV," the authors wrote. "Therefore, the confirmation that the incidence of major CVE is increased the year following COVID-19 in PWH, including those non-hospitalized or without prior CVE, deserves major awareness."
The authors said reasons for the increased risk are unknown and multifactorial. Earlier studies have suggested PWH have elevated levels of T-cell and inflammatory markers after COVID-19.