Abstract P515: HIV/HCV Co-Infection and the Risk of Cardiovascular Disease: A Meta-Analysis of 91,153 Patients

Abstract

Introduction: Antiretroviral therapy has improved the life expectancy of people living with human immunodeficiency virus (HIV). However, these patients are more susceptible to developing cardiovascular diseases (CVD) and subsequent mortalities. Many studies examining the association between HIV and hepatitis C virus (HCV) co-infection and the risk of CVD, compared to HIV mono-infection, have inconsistent results. We conducted a meta-analysis to quantify this association. We hypothesized that CVD risk will be synergistically increased by the persistent inflammatory responses of dual viral infections. Method: We searched Pubmed, EMBASE, CINAHL, Google Scholar, Cochrane, and Web of Science from inception to July 2022 to identify studies on HIV/HCV co-infection and CVD, defined as coronary artery disease, congestive heart failure, and stroke. We used either a random or fixed effect model considering the heterogeneity. Adjusted hazard ratios (aHR) and crude Odds ratio (COR) for CVD and mortality were used. Results: Among the 453 articles reviewed, 11 observational studies met the inclusion criteria, with a total of 91,153 participants. Of these, 9633 (10.5%) were HIV/HCV coinfected, 81,520 (89.5%) were HIV monoinfected. Pooled hazard ratio for the association between HIV/HCV co-infection and CVD was significant (aHR = 1.45, 95% CI: 1.24, 1.65, I2 = 38%, P=0.12) compared to HIV mono-infection. Furthermore, the odds of mortality due to HIV/HCV co-infection in patients with CVD is significantly higher compared to HIV mono-infection (COR = 4.07, 95% CI: 3.19, 5.18, I2 = 0%, P=0.56). Conclusion: We found a positive association between HIV/HCV coinfection and increased CVD risk and associated mortality compared to those with HIV mono-infection. However, more research is needed for further assessment of this association, determining potential underlying mechanisms and evaluating whether treatment for HIV and HCV infections can reduce CVD morbidities and mortalities.