HealthDay News — Persons living with HIV (PHIV) who are hospitalized with heart failure are at an increased risk for subsequent sudden cardiac death (SCD), according to a study published online Aug. 7 in JACC: Heart Failure.
Raza M. Alvi, MD, from Massachusetts General Hospital in Boston, and colleagues retrospectively analyzed data from 2578 patients hospitalized with heart failure from a single academic center; 344 of these patients were PHIV. The incidence of SCD was evaluated by viral load.
The researchers found that 86% of included patients did not have an implantable cardioverter defibrillator (ICD; 344 PHIV and 1,805 uninfected controls). The vast majority of PHIV with heart failure were prescribed antiretroviral therapy (91%), and 64% were virally suppressed. During a median follow-up of 19 months, there were 191 SCDs. PHIV had a threefold increase in SCD (21 vs 6.4%; adjusted odds ratio, 3.0) compared with controls. SCD predictors among PHIV included cocaine use, lower left ventricular ejection fraction, absence of beta-blocker prescription, lower CD4 count, and higher viral load. PHIV with an undetectable viral load had an SCD rate similar to that of HIV-uninfected individuals. The rate of SCD was 10% per year among PHIV with heart failure without a conventional indication for an ICD.
“This study advances our understanding of SCD among PHIV with heart failure, re-emphasizing the already recognized importance of disease control among PHIV regardless of LVEF,” the authors write.