August 24, 2016 | JAMA Cardiology
People with HIV are living longer and are now at an increased risk for cardiovascular disease (CVD). There is an urgent need to identify novel risk factors and primary prevention approaches for CVD in HIV.
Although depression is prevalent in HIV-positive patients and is associated with future CVD in the general population, its association with CVD events has not been examined in the HIV-infected population.
Matthew S. Freiberg, MD, Vanderbilt University School of Medicine, Nashville, Tennessee, and colleagues conducted a study that included 26,144 HIV-positive veterans without CVD at baseline (1998-2003) participating in the US Department of Veterans Affairs Veterans Aging Cohort Study from April 2003 through December 2009. At study entry, 4,853 veterans (19%) with MDD were identified.
During 5.8 years of follow-up, 490 acute MI events occurred. After adjustment for demographics, CVD risk factors, and HIV-specific factors, the researchers found that HIV-positive patients with MDD had a 30% greater risk for having an acute MI than did HIV-positive patients without MDD.
This elevation in acute MI risk was slightly lessened to 25% after further adjustment for other variables, such as hepatitis C infection, kidney disease, alcohol/cocaine abuse or dependence, and haemoglobin levels.
“Our findings raise the possibility that, similar to the general population, MDD may be independently associated with incident atherosclerotic CVD in the HIV-infected population,” the authors wrote. “Considering the dearth of research in this area, future epidemiologic and mechanistic studies that include women and non-VA populations with HIV are needed.”