{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:10:45Z","timestamp":1780528245543,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,9,15]],"date-time":"2014-09-15T00:00:00Z","timestamp":1410739200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiovascular and cerebrovascular (<jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>) events\/diseases are a common cause of non\u2013acquired immunodeficiency syndrome (<jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content>)\u2010related mortality in the aging human immunodeficiency virus (<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>)\u2010infected population. The incidence rate and clinical correlates of <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> in people living with <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content> compared to the general population warrants further investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>HIV\/AIDS is associated with increased risk CVD compared to general population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> events in a matched cohort of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected and non\u2013<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected adults, \u226518 years old, served through the South Carolina Medicaid program during 1994 to 2011 were examined using time\u2010dependent proportional hazards regression and marginal structural modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A retrospective cohort of 13\u2009632 adults was followed longitudinally for an average of 51 months. The adjusted hazard ratio (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>) of incident <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> events was higher among <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected individuals exposed to combination antiretroviral therapy (<jats:styled-content style=\"fixed-case\">cART<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> = 1.15) compared to the non\u2013<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected group, but did not differ from the subgroup of <jats:styled-content style=\"fixed-case\">cART<\/jats:styled-content>\u2010na\u00efve <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected adults. A higher <jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> of incident <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> was associated with comorbid hypertension (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> = 2.18), diabetes (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> = 1.38), obesity (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> = 1.30), tobacco use (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> = 1.47), and hepatitis C coinfection (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> = 1.32), and older age (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> = 1.26), but with a lower risk among females (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> = 0.86). A higher risk of incident <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> events was also apparent in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected individuals with exposure to both protease inhibitors (adjusted risk ratio [<jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content>]\u2009=\u20091.99) and non\u2010nucleoside reverse transcriptase inhibitors (<jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content> = 2.19) compared to those with no exposure. Sustained viral load suppression was associated with a lower risk of incident <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> events (<jats:styled-content style=\"fixed-case\">aRR<\/jats:styled-content> = 0.74).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>After adjusting for traditional risk factors and sociodemographic differences, there is higher risk of incident cardiovascular events among <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected individuals exposed to combined antiretroviral medications compared to the general population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22311","type":"journal-article","created":{"date-parts":[[2014,9,20]],"date-time":"2014-09-20T10:15:39Z","timestamp":1411208139000},"page":"517-522","source":"Crossref","is-referenced-by-count":28,"title":["Impact of Clinical and Therapeutic Factors on Incident Cardiovascular and Cerebrovascular Events in a Population\u2010Based Cohort of <scp>HIV<\/scp>\u2010Infected and Non\u2013<scp>HIV<\/scp>\u2010Infected Adults"],"prefix":"10.1002","volume":"37","author":[{"given":"Avnish","family":"Tripathi","sequence":"first","affiliation":[{"name":"Department of Medicine University of Mississippi School of Medicine  Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela D.","family":"Liese","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Winniford","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Mississippi School of Medicine  Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette M.","family":"Jerrell","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry and Behavioral University of South Carolina School of Medicine Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Albrecht","sequence":"additional","affiliation":[{"name":"Department of Medicine University of South Carolina School of Medicine Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali A.","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Department of Medicine University of South Carolina School of Medicine Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne A.","family":"Duffus","sequence":"additional","affiliation":[{"name":"Department of Medicine University of South Carolina School of Medicine Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31815e7251"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/652283"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/103063"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-2190"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00126334-200208150-00002"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31821d33a5"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2012.00996.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062744"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2008.161463"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0059551"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000015"},{"key":"e_1_2_6_13_1","first-page":"221","article-title":"Prevalence of highly active antiretroviral therapy associated metabolic abnormalities and lipodystrophy in HIV infected patients","volume":"50","author":"Feleke Y","year":"2012","journal-title":"Ethiop Med J."},{"key":"e_1_2_6_14_1","unstructured":"Coca\u2010Perraillon M. 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