Leukocyte Count and Coronary Artery Disease Events in People with Human Immunodeficiency Virus: A Longitudinal Study
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Leukocyte Count and Coronary Artery Disease Events in People with Human Immunodeficiency Virus : A Longitudinal Study. / Avery, Emma F.; Kleynhans, Julia N.; Ledergerber, Bruno; Schoepf, Isabella C.; Thorball, Christian W.; Kootstra, Neeltje A.; Reiss, Peter; Ryom, Lene; Braun, Dominique L.; Thurnheer, Maria C.; Marzolini, Catia; Seneghini, Marco; Bernasconi, Enos; Cavassini, Matthias; Buvelot, Hélène; Kouyos, Roger D.; Fellay, Jacques; Günthard, Huldrych F.; Tarr, Philip E.
In: Clinical Infectious Diseases, Vol. 76, No. 11, 2023, p. 1969-1979.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Leukocyte Count and Coronary Artery Disease Events in People with Human Immunodeficiency Virus
T2 - A Longitudinal Study
AU - Avery, Emma F.
AU - Kleynhans, Julia N.
AU - Ledergerber, Bruno
AU - Schoepf, Isabella C.
AU - Thorball, Christian W.
AU - Kootstra, Neeltje A.
AU - Reiss, Peter
AU - Ryom, Lene
AU - Braun, Dominique L.
AU - Thurnheer, Maria C.
AU - Marzolini, Catia
AU - Seneghini, Marco
AU - Bernasconi, Enos
AU - Cavassini, Matthias
AU - Buvelot, Hélène
AU - Kouyos, Roger D.
AU - Fellay, Jacques
AU - Günthard, Huldrych F.
AU - Tarr, Philip E.
N1 - Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2023
Y1 - 2023
N2 - Background: People with human immunodeficiency virus (HIV; PWH) have increased cardiovascular risk. Higher leukocyte count has been associated with coronary artery disease (CAD) events in the general population. It is unknown whether the leukocyte-CAD association also applies to PWH. Methods: In a case-control study nested within the Swiss HIV Cohort Study, we obtained uni-and multivariable odds ratios (OR) for CAD events, based on traditional and HIV-related CAD risk factors, leukocyte count, and confounders previously associated with leukocyte count. Results: We included 536 cases with a first CAD event (2000-2021; median age, 56 years; 87% male; 84% with suppressed HIV RNA) and 1464 event-free controls. Cases had higher latest leukocyte count before CAD event than controls (median [interquartile range], 6495 [5300-7995] vs 5900 [4910-7200]; P <. 01), but leukocytosis (>11 000/μL) was uncommon (4.3% vs 2.1%; P =. 01). In the highest versus lowest leukocyte quintile at latest time point before CAD event, participants had univariable CAD-OR = 2.27 (95% confidence interval, 1.63-3.15) and multivariable adjusted CAD-OR = 1.59 (1.09-2.30). For comparison, univariable CAD-OR for dyslipidemia, diabetes, and recent abacavir exposure were 1.58 (1.29-1.93), 2.19 (1.59-3.03), and 1.73 (1.37-2.17), respectively. Smoking and, to a lesser degree, alcohol and ethnicity attenuated the leukocyte-CAD association. Leukocytes measured up to 8 years before the event were significantly associated with CAD events. Conclusions: PWH in Switzerland with higher leukocyte counts have an independently increased risk of CAD events, to a degree similar to traditional and HIV-related risk factors.
AB - Background: People with human immunodeficiency virus (HIV; PWH) have increased cardiovascular risk. Higher leukocyte count has been associated with coronary artery disease (CAD) events in the general population. It is unknown whether the leukocyte-CAD association also applies to PWH. Methods: In a case-control study nested within the Swiss HIV Cohort Study, we obtained uni-and multivariable odds ratios (OR) for CAD events, based on traditional and HIV-related CAD risk factors, leukocyte count, and confounders previously associated with leukocyte count. Results: We included 536 cases with a first CAD event (2000-2021; median age, 56 years; 87% male; 84% with suppressed HIV RNA) and 1464 event-free controls. Cases had higher latest leukocyte count before CAD event than controls (median [interquartile range], 6495 [5300-7995] vs 5900 [4910-7200]; P <. 01), but leukocytosis (>11 000/μL) was uncommon (4.3% vs 2.1%; P =. 01). In the highest versus lowest leukocyte quintile at latest time point before CAD event, participants had univariable CAD-OR = 2.27 (95% confidence interval, 1.63-3.15) and multivariable adjusted CAD-OR = 1.59 (1.09-2.30). For comparison, univariable CAD-OR for dyslipidemia, diabetes, and recent abacavir exposure were 1.58 (1.29-1.93), 2.19 (1.59-3.03), and 1.73 (1.37-2.17), respectively. Smoking and, to a lesser degree, alcohol and ethnicity attenuated the leukocyte-CAD association. Leukocytes measured up to 8 years before the event were significantly associated with CAD events. Conclusions: PWH in Switzerland with higher leukocyte counts have an independently increased risk of CAD events, to a degree similar to traditional and HIV-related risk factors.
KW - coronary artery disease
KW - HIV infection
KW - leukocytes
KW - multivariable analysis
KW - white blood cells
U2 - 10.1093/cid/ciad033
DO - 10.1093/cid/ciad033
M3 - Journal article
C2 - 36688465
AN - SCOPUS:85162265632
VL - 76
SP - 1969
EP - 1979
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 11
ER -
ID: 396730035