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Bispebjerg Hospital - a part of Copenhagen University Hospital
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HIV infection is associated with thoracic and abdominal aortic aneurysms: a prospective matched cohort study

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  • Julie Høgh
  • Michael Huy Cuong Pham
  • Andreas Dehlbæk Knudsen
  • Rebekka Faber Thudium
  • Marco Gelpi
  • Per Ejlstrup Sigvardsen
  • Andreas Fuchs
  • Jørgen Tobias Kühl
  • Shoaib Afzal
  • Børge Grønne Nordestgaard
  • Thomas Benfield
  • Lars Køber
  • Jan Gerstoft
  • Klaus Fuglsang Kofoed
  • Susanne Dam Nielsen
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AIMS: Little is known about the prevalence of aortic aneurysms among people living with HIV (PLWH). We investigated whether HIV status is independently associated with having aortic aneurysms. Furthermore, we determined risk factors associated with aortic aneurysms in PLWH.

METHODS AND RESULTS: PLWH aged ≥40 years (n = 594) were recruited from the Copenhagen Comorbidity in HIV Infection study and matched for age and sex with uninfected controls (n = 1188) from the Copenhagen General Population Study. Aortic dimensions were assessed using contrast enhanced computed tomography. Aortic aneurysms were defined according to the European Society of Cardiology guidelines, i.e. an aortic dilation of ≥50% or an infrarenal aortic diameter of ≥30 mm. Among PLWH and uninfected controls, the median (interquartile range) age was 52 (47-60) and 52 (48-61) and 88% and 90% were male, respectively. We found 46 aneurysms in 42 (7.1%) PLWH and 31 aneurysms in 29 (2.4%) uninfected controls (P < 0.001). PLWH had a significantly higher prevalence of ascending aortic aneurysms and infrarenal aortic aneurysms. In an adjusted model, HIV was independently associated with aortic aneurysms (adjusted odds ratio; 4.51 [95% confidence interval 2.56-8.08], P < 0.001). Within PLWH, obesity and hepatitis B co-infection were associated with aortic aneurysms.

CONCLUSION: PLWH had four-fold higher odds of aortic aneurysms compared to uninfected controls, and HIV status was independently associated with aortic aneurysms. Among PLWH, age, obesity and hepatitis B co-infection were associated with higher odds of aortic aneurysms. Our findings suggest that increased attention to aortic aneurysms in PLWH may be beneficial.

Original languageEnglish
JournalEuropean Heart Journal
Volume42
Issue number30
Pages (from-to)2924-2931
Number of pages8
ISSN0195-668X
DOIs
Publication statusPublished - 7 Aug 2021

    Research areas

  • HIV, Aortic aneurysm, Syphilis, Comorbidity, Computed tomography imaging

ID: 66725100