Rotger M, Glass TR, Junier T, Lundgren J, Neaton JD, Poloni ES, van 't Wout AB, Lubomirov R, Colombo S, Martinez R, Rauch A, Günthard HF, Neuhaus J, Wentworth D, van Manen D, Gras LA, Schuitemaker H, Albini L, Torti C, Jacobson LP, Li X, Kingsley LA, Carli F, Guaraldi G, Ford ES, Sereti I, Hadigan C, Martinez E, Arnedo M, Egaña-Gorroño L, Gatell JM, Law M, Bendall C, Petoumenos K, Rockstroh J, Wasmuth JC, Kabamba K, Delforge M, De Wit S, Berger F, Mauss S, de Paz Sierra M, Losso M, Belloso WH, Leyes M, Campins A, Mondi A, De Luca A, Bernardino I, Barriuso-Iglesias M, Torrecilla-Rodriguez A, Gonzalez-Garcia J, Arribas JR, Fanti I, Gel S, Puig J, Negredo E, Gutierrez M, Domingo P, Fischer J, Fätkenheuer G, Alonso-Villaverde C, Macken A, Woo J, McGinty T, Mallon P, Mangili A, Skinner S, Wanke CA, Reiss P, Weber R, Bucher HC, Fellay J, Telenti A, Tarr PE. Contribution of genetic background, traditional risk factors, and HIV-related factors to coronary artery disease events in HIV-positive persons.
Clin Infect Dis 2013;
57:112-21. [PMID:
23532479 DOI:
10.1093/cid/cit196]
[Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND
Persons infected with human immunodeficiency virus (HIV) have increased rates of coronary artery disease (CAD). The relative contribution of genetic background, HIV-related factors, antiretroviral medications, and traditional risk factors to CAD has not been fully evaluated in the setting of HIV infection.
METHODS
In the general population, 23 common single-nucleotide polymorphisms (SNPs) were shown to be associated with CAD through genome-wide association analysis. Using the Metabochip, we genotyped 1875 HIV-positive, white individuals enrolled in 24 HIV observational studies, including 571 participants with a first CAD event during the 9-year study period and 1304 controls matched on sex and cohort.
RESULTS
A genetic risk score built from 23 CAD-associated SNPs contributed significantly to CAD (P = 2.9 × 10(-4)). In the final multivariable model, participants with an unfavorable genetic background (top genetic score quartile) had a CAD odds ratio (OR) of 1.47 (95% confidence interval [CI], 1.05-2.04). This effect was similar to hypertension (OR = 1.36; 95% CI, 1.06-1.73), hypercholesterolemia (OR = 1.51; 95% CI, 1.16-1.96), diabetes (OR = 1.66; 95% CI, 1.10-2.49), ≥ 1 year lopinavir exposure (OR = 1.36; 95% CI, 1.06-1.73), and current abacavir treatment (OR = 1.56; 95% CI, 1.17-2.07). The effect of the genetic risk score was additive to the effect of nongenetic CAD risk factors, and did not change after adjustment for family history of CAD.
CONCLUSIONS
In the setting of HIV infection, the effect of an unfavorable genetic background was similar to traditional CAD risk factors and certain adverse antiretroviral exposures. Genetic testing may provide prognostic information complementary to family history of CAD.
Collapse