Cardiovascular risk in patients visiting the Hadassah AIDS Center, Jerusalem

To evaluate cardiovascular risk (CVR) in patients visiting Hadassah AIDS Center & to characterize clinical parameters of patients with high CVR.

We analyzed data of 150/350 clinic consecutive patients (median age 41 years, range 24-79; 60% males). Sub-Saharan Africans comprised 51% of patients, mainly immigrants from Ethiopia. Most patients (90%) were on ART, 62% were treated with PIs. Median time for ART and PI exposure were 7 and 4 years, respectively. Most patients (88%) defined adherence to ART>90%. High adherence correlated with viral suppression (p=0.039), but not with increase in CD4. Analyzing traditional CVRs, we observed higher rate of hypertension (HTN) among HIV+ patients compared to the general Israeli population (20% vs. 15%, respectively). In 16% of Ethiopians HTN was likewise observed. HTN rates were 20% among ART-experienced patients, 22% in PI-exposed patients, and 16% among ART-naïve patients. The prevalence of diabetes was 5.7%, similar to the general Israeli population. It was higher among Ethiopians (8%). The rate of smoking was 25% in HIV+ patients, similar to general population (24%) and lower in Ethiopians (8%). Overall increased CVR was observed in 21% of all patients (FRS ≥10%). In 13% the MS was diagnosed. Lower rate of increased CVR (11% only) was observed among HIV+ Ethiopians. Increased CVR was correlated with increased age (p<0.05), male gender (p=0.034), HTN (p=0.002), but not with smoking (p=0.53), change of CD4 (p=0.7) or viral suppression (p=0.64). Increased duration of HIV infection and longer exposure to ART were noted in patients with increased FRS (p=0.059 and p=0.06, respectively), but not so for PI exposure (p=0.1). In 17% of patients LDL-cholesterol levels were higher than optimal goal, as set for CVR factors, especially in the group with increased FRS (p<0.05). Including HIV infection & ART per se as independent CVR, led to LDL goal above target in 30% of the patients in this cohort.