Leukocyte Count and Coronary Artery Disease Events in People with Human Immunodeficiency Virus: A Longitudinal Study
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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.
Original language | English |
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Journal | Clinical Infectious Diseases |
Volume | 76 |
Issue number | 11 |
Pages (from-to) | 1969-1979 |
Number of pages | 11 |
ISSN | 1058-4838 |
DOIs | |
Publication status | Published - 2023 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.
- coronary artery disease, HIV infection, leukocytes, multivariable analysis, white blood cells
Research areas
ID: 396730035