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And, in fact, in different cohorts deaths range from 6 to 15%. Depending on the cohort, cardiovascular disease is the second nonleading is the second leading non-HIV cause of death in the US, accounting for 15% of deaths of HIV-infected individuals, and in Europe, it is the third leading non-HIV cause of death. Hsue, MD: We’re now having a growing body of evidence to show the link between cardiovascular disease and mortality in the setting of HIV. ART, antiretroviral therapy CVD, cardiovascular disease MI, myocardial infarction.And using different imaging modalities, investigators have shown that HIV-infected men have a higher prevalence of coronary artery plaque. Other studies have shown that HIV is a risk factor of ischemic stroke. And you can see here on this diagram that this increased risk of HIV patients compared to uninfected patients, this higher risk was present at different age brackets, including patients who were very young. This is a study looking at patients with myocardial infarction treated in the Boston healthcare system showing that rates of acute myocardial infarction were higher in HIV-infected individuals. Hsue, MD: On this slide, we discuss a link between HIV and cardiovascular disease. CVD, cardiovascular disease MI, myocardial infarction PY, person-years.
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And, in fact, mechanistic drivers of cardiovascular disease in HIV may include a combination of traditional risk factors, including smoking, along with nontraditional factors, including antiretroviral therapy, chronic inflammation, and HIV infection itself, along with antiretroviral therapy. And, interestingly, the impact of HIV on cardiovascular risk was comparable to very strong traditional risk factors, including hypertension, diabetes, and hyperlipidemia. This increased risk remained even among those with HIV who were well treated and suppressed.

Hsue, MD: We know from Freiberg and colleagues’ study with the Veterans’ Affairs Cohort that HIV infection is associated with a 50% increased risk for acute myocardial infarction even after adjustment for traditional risk factors.

We’ll next then move on to assessing cardiovascular disease risks among HIV-infected individuals. We’ll first start with discussing the epidemiology of cardiovascular disease in the setting of HIV infection. Hsue, MD: I will provide an overview of today’s presentation.
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