Human Immunodeficiency Virus Infection and Risk of Heart Failure Readmissions

Abstract

Background Human Immunodeficiency Infection (HIV) is associated with increased risk for heart failure (HF). Outcomes of HF in people living with HIV (PLHIV) are unknown. We sought to identify the risk of HF readmissions (30 and 90 days) among PLHIV vs uninfected controls admitted with HF. Methods Using the 2016 national readmission database, we identified all patients (≥ 18 years) who were discharged alive with a primary diagnosis of HF (ICD10 I50.xx) with or without secondary diagnosis of HIV (ICD 10 Z21, B20, O98.7, or B97.35). Propensity score matching (PSM) was used to match PLHIV with controls (1:1) based on 45 patient characteristics (demographics, hospitalization characteristics, and comorbidities). Cox regression models were used to compare rates of HF readmission (primary ICD10 I50.xx) within 30 and 90 days after discharge from index HF hospitalization. Results A total of 312,264 patients with HF were identified, of whom 1,112 (0.4%) had HIV. After PSM, 1,112 PLHIV were matched with 1,112 uninfected controls. The standard mean difference for each variable was less than 10% post-matching. Overall, HF readmission rates were 11.2% and 19.2% at 30 and 90 days, respectively. The two groups (PLHIV and controls) were not different statistically with respect to all 45 covariates. Compared with controls, PLHIV had higher risk of HF readmission within 30 days (HR 1.45, 95% CI: 1.13-1.87, P=0.004) and 90 days (HR 1.41, 95% CI 1.16-1.71, P Conclusions In this propensity-matched national cohort of patients admitted with HF, patients with HIV appear to have increased risk of HF readmissions compared with uninfected controls at 30 days and 90 days.