TY - JOUR
T1 - Leukocyte Count and Coronary Artery Disease Events in People with Human Immunodeficiency Virus
T2 - A Longitudinal Study
AU - Avery, Emma F.
AU - Kleynhans, Julia N.
AU - Ledergerber, Bruno
AU - Schoepf, Isabella C.
AU - Thorball, Christian W.
AU - Kootstra, Neeltje A.
AU - Reiss, Peter
AU - Ryom, Lene
AU - Braun, Dominique L.
AU - Thurnheer, Maria C.
AU - Marzolini, Catia
AU - Seneghini, Marco
AU - Bernasconi, Enos
AU - Cavassini, Matthias
AU - Buvelot, H. lène
AU - Kouyos, Roger D.
AU - Fellay, Jacques
AU - Günthard, Huldrych F.
AU - Tarr, Philip E.
N1 - Funding Information: Financial support. This work was supported by the SHCS [project 836], the Swiss National Science Foundation (grant number 201369), and the SHCS Research Foundation. SHCS data are gathered by the 5 Swiss university hospitals, 2 cantonal hospitals, 15 affiliated hospitals, and 36 private physicians (listed in http://www.shcs.ch/180-health-care-providers ). B. L. reports support for this work from Kantonsspital Baselland (Data management and analyses). Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Background: People with human immunodeficiency virus (HIV; PWH) have increased cardiovascular risk. Higher leukocyte count has been associated with coronary artery disease (CAD) events in the general population. It is unknown whether the leukocyte-CAD association also applies to PWH. Methods: In a case-control study nested within the Swiss HIV Cohort Study, we obtained uni-and multivariable odds ratios (OR) for CAD events, based on traditional and HIV-related CAD risk factors, leukocyte count, and confounders previously associated with leukocyte count. Results: We included 536 cases with a first CAD event (2000-2021; median age, 56 years; 87% male; 84% with suppressed HIV RNA) and 1464 event-free controls. Cases had higher latest leukocyte count before CAD event than controls (median [interquartile range], 6495 [5300-7995] vs 5900 [4910-7200]; P <. 01), but leukocytosis (>11 000/μL) was uncommon (4.3% vs 2.1%; P =. 01). In the highest versus lowest leukocyte quintile at latest time point before CAD event, participants had univariable CAD-OR = 2.27 (95% confidence interval, 1.63-3.15) and multivariable adjusted CAD-OR = 1.59 (1.09-2.30). For comparison, univariable CAD-OR for dyslipidemia, diabetes, and recent abacavir exposure were 1.58 (1.29-1.93), 2.19 (1.59-3.03), and 1.73 (1.37-2.17), respectively. Smoking and, to a lesser degree, alcohol and ethnicity attenuated the leukocyte-CAD association. Leukocytes measured up to 8 years before the event were significantly associated with CAD events. Conclusions: PWH in Switzerland with higher leukocyte counts have an independently increased risk of CAD events, to a degree similar to traditional and HIV-related risk factors.
AB - Background: People with human immunodeficiency virus (HIV; PWH) have increased cardiovascular risk. Higher leukocyte count has been associated with coronary artery disease (CAD) events in the general population. It is unknown whether the leukocyte-CAD association also applies to PWH. Methods: In a case-control study nested within the Swiss HIV Cohort Study, we obtained uni-and multivariable odds ratios (OR) for CAD events, based on traditional and HIV-related CAD risk factors, leukocyte count, and confounders previously associated with leukocyte count. Results: We included 536 cases with a first CAD event (2000-2021; median age, 56 years; 87% male; 84% with suppressed HIV RNA) and 1464 event-free controls. Cases had higher latest leukocyte count before CAD event than controls (median [interquartile range], 6495 [5300-7995] vs 5900 [4910-7200]; P <. 01), but leukocytosis (>11 000/μL) was uncommon (4.3% vs 2.1%; P =. 01). In the highest versus lowest leukocyte quintile at latest time point before CAD event, participants had univariable CAD-OR = 2.27 (95% confidence interval, 1.63-3.15) and multivariable adjusted CAD-OR = 1.59 (1.09-2.30). For comparison, univariable CAD-OR for dyslipidemia, diabetes, and recent abacavir exposure were 1.58 (1.29-1.93), 2.19 (1.59-3.03), and 1.73 (1.37-2.17), respectively. Smoking and, to a lesser degree, alcohol and ethnicity attenuated the leukocyte-CAD association. Leukocytes measured up to 8 years before the event were significantly associated with CAD events. Conclusions: PWH in Switzerland with higher leukocyte counts have an independently increased risk of CAD events, to a degree similar to traditional and HIV-related risk factors.
KW - HIV infection
KW - coronary artery disease
KW - leukocytes
KW - multivariable analysis
KW - white blood cells
UR - http://www.scopus.com/inward/record.url?scp=85162265632&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/cid/ciad033
DO - https://doi.org/10.1093/cid/ciad033
M3 - Article
C2 - 36688465
SN - 1058-4838
VL - 76
SP - 1969
EP - 1979
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 11
ER -