Background
People with HIV (PWH) have higher risk of heart failure (HF) due to traditional and HIV-related factors. Risk prediction of HF in PWH is not well characterized.
Methods
We calculated the PREVENT (Predicting Risk of Cardiovascular Disease Events) 10-year risk of HF for all REPRIEVE participants. HF incidence (events/1000 person years) was described overall and by demographic, HF and HIV-specific factors. Confirmed HF events included adjudicated HF hospitalization and adverse events identified via a standardized Medical Dictionary for Regulatory Archives query.
Results
We analyzed 7,769 REPRIEVE participants from five global regions (median 50 years, 31% female, 22% Black of those from high-income region). Median (Q1, Q3) PREVENT HF score was 1.66% (1.01, 2.62). HF incidence was 1.65/1000 person years (95% CI 1.30-2.09) with similar rates by randomized arm. Expected number of HF events by PREVENT HF (73) was similar to observed (67). Median PREVENT HF risk was higher at baseline in those with vs without confirmed HF events (2.22 vs 1.39%). HF incidence was higher in women, among Black or African Americans in high-income regions, participants in sub-Saharan Africa, and among those with pre-existing hypertension and elevated body mass index compared to absence of these factors (Figure).
Conclusions
In PWH, observed number of HF events aligned with the low estimated PREVENT HF risk rates. Demographics, clinical factors, and global region may contribute to a higher incidence of HF events among PWH.