Table 2. Characteristics of Patients (N = 2,005), by 10-Year Cardiovascular Risk (CVR) Category, HIV Outpatient Study (HOPS), January 2002–September 2009.
| Characteristica | 10-Year CVR Category | P Valueb | ||||
|---|---|---|---|---|---|---|
|
| ||||||
| Overall (N = 2,005) | Low Risk (<10% Risk), ≤1Risk Factor (n = 675) | Moderate Risk (<10% Risk), ≥2 Risk Factors (n = 565) | Moderately High Risk (10%–20% Risk), ≥2 Risk Factors (n = 365) | High Risk (>20% Risk), ≥2 Risk Factors (n = 400) | ||
|
| ||||||
| Baseline | ||||||
| Age, y, median | 42 | 38 | 41 | 47 | 48 | <.001 |
| Male sex | 1,532 (76) | 451 (67) | 405 (72) | 350 (96) | 326 (82) | <.001 |
| Race/ethnicity | ||||||
| White, non-Hispanic | 1,048 (52) | 304 (45) | 276 (49) | 252 (69) | 216 (54) | <.001 |
| Black, non-Hispanic | 657 (33) | 251 (37) | 199 (35) | 73 (20) | 134 (34) | |
| Hispanic | 239 (12) | 93 (14) | 71 (13) | 31 (8) | 44 (11) | |
| Other | 61 (3) | 27 (4) | 19 (3) | 9 (2) | 6 (2) | |
| Year of HOPS entry | ||||||
| 1998 or earlier | 856 (43) | 247 (37) | 210 (37) | 176 (48) | 223 (56) | <.001 |
| 1999–2005 | 1,149 (57) | 428 (63) | 355 (63) | 189 (52) | 177 (44) | |
| Private insurance | 1,147 (57) | 420 (62) | 293 (52) | 233 (64) | 201 (50) | <.001 |
| History of IDU | 227 (11) | 37 (5) | 90 (16) | 38 (10) | 62 (16) | <.001 |
| Prior AIDS-defining illness | 728 (36) | 209 (31) | 204 (36) | 139 (38) | 176 (44) | <.001 |
| Cell count/viral load | ||||||
| Nadir CD4+ T cell count <200 cells/mm3 | 1,016 (51) | 314 (47) | 296 (52) | 191 (52) | 215 (54) | .06 |
| Nadir CD4+ T cell count, cells/mm3, median | 197 | 218 | 187 | 190 | 180 | .27 |
| CD4+ T cell count, cells/mm3, median | 395 | 396 | 358 | 401 | 415 | .002 |
| Peak viral load, copies/mL, median | 5,985 | 7,790 | 19,712 | 1,911 | 2,384 | <.001 |
| Viral load, copies/mL, median | 419 | 745 | 908 | 200 | 200 | <.001 |
| Viral load <400 copies/mL | 988 (49) | 305 (45) | 244 (43) | 211 (58) | 228 (57) | <.001 |
| Alcohol use, drinks/week | ||||||
| Missing information | 127 (6) | 49 (7) | 32 (6) | 18 (5) | 28 (7) | <.001 |
| 0 | 977 (49) | 322 (48) | 284 (50) | 146 (40) | 225 (56) | |
| <7 | 689 (34) | 242 (36) | 192 (34) | 144 (39) | 111 (28) | |
| 7–14 | 124 (6) | 40 (6) | 30 (5) | 31 (8) | 23 (6) | |
| >14 | 88 (4) | 22 (3) | 27 (5) | 26 (7) | 13 (3) | |
| BMI, kg/m2 | ||||||
| Missing information | 120 (6) | 47 (7) | 36 (6) | 21 (6) | 16 (4) | .005 |
| ≤25 | 909 (45) | 331 (49) | 261 (46) | 160 (44) | 157 (39) | |
| >25 | 976 (49) | 297 (44) | 268 (47) | 184 (50) | 227 (57) | |
| Hypertension | 1,036 (52) | 112 (17) | 356 (63) | 230 (63) | 338 (85) | <.001 |
| Diabetes mellitus | 190 (9) | 0 | 0 | 0 | 190 (48) | <.001 |
| History of tobacco use | 1,108 (55) | 164 (24) | 348 (62) | 296 (81) | 300 (75) | <.001 |
| Blood lipid panel measurement | ||||||
| Total cholesterol, mg/dL, median | 204 | 197 | 181 | 226 | 238 | <.001 |
| LDL cholesterol, mg/dL, median | 105 | 108 | 94 | 114 | 107 | <.001 |
| HDL cholesterol, mg/dL, median | 37 | 44 | 35 | 35 | 35 | <.001 |
| Non-HDL cholesterol, mg/dL, medianc | 164 | 151 | 142 | 186 | 199 | <.001 |
| Triglycerides, mg/dL, median | 163 | 126 | 162 | 200 | 225 | <.001 |
| Metabolic syndromed | 516 (26) | 85 (13) | 157 (28) | 103 (28) | 171 (43) | <.001 |
| Antiretroviral therapy | ||||||
| Efavirenz | 452 (23) | 157 (23) | 136 (24) | 66 (18) | 93 (23) | .14 |
| Nevirapine | 213 (11) | 65 (10) | 63 (11) | 38 (10) | 47 (12) | .70 |
| Protease inhibitor, unboosted | 222 (11) | 62 (9) | 72 (13) | 41 (11) | 47 (12) | .23 |
| Protease inhibitor, boosted | 626 (31) | 205 (30) | 171 (30) | 126 (35) | 124 (31) | .51 |
| Zidovudine or Stavudine | 775 (39) | 233 (35) | 230 (41) | 143 (39) | 169 (42) | .043 |
| Didanosine | 273 (14) | 78 (12) | 72 (13) | 62 (17) | 61 (15) | .07 |
| Abacavir | 443 (22) | 139 (21) | 132 (23) | 81 (22) | 91 (23) | .68 |
| Tenofovir | 561 (28) | 174 (26) | 181 (32) | 92 (25) | 114 (29) | .055 |
| Lipid-lowering agents | ||||||
| Statin drug/ezitimibe | 245 (12) | 42 (6) | 31 (5) | 49 (13) | 123 (31) | <.001 |
| Fibrate | 116 (6) | 13 (2) | 16 (3) | 26 (7) | 61 (15) | <.001 |
| Fish oil | 17 (1) | 4 (1) | 3 (1) | 2 (1) | 8 (2) | .09 |
|
| ||||||
| Follow-Up | ||||||
|
| ||||||
| Follow-up after baseline, y, median | 5.5 | 5.5 | 5.5 | 5.8 | 5.1 | .32 |
| Lipid-lowering agents | ||||||
| Statin drug/ezitimibe | 562 (28) | 119 (18) | 109 (19) | 125 (34) | 209 (52) | <.001 |
| Fibrate | 235 (12) | 39 (6) | 53 (9) | 54 (15) | 89 (22) | <.001 |
| Fish oil | 139 (7) | 25 (4) | 42 (7) | 33 (9) | 39 (10) | <.001 |
| ARV regimen changese | 1,353 (67) | 442 (65) | 380 (67) | 260 (71) | 271 (68) | .30 |
| Antihypertensives | 633 (32) | 52 (8) | 212 (38) | 136 (37) | 233 (58) | <.001 |
| Incident CVD | 148 (7) | 14 (2) | 27 (5) | 45 (12) | 62 (16) | <.001 |
Abbreviations: IDU, intravenous drug use; AIDS, acquired immunodeficiency syndrome; BMI, body mass index; LDL, low-density lipoprotein; HDL, high-density lipoprotein; ARV, antiretroviral.
Values presented as n (%) unless otherwise indicated.
χ2 test for binary variables or Kruskal–Wallis test for continuous variables.
Non-HDL cholesterol equals total cholesterol minus HDL cholesterol.
Defined as the presence of any 3 of the following 5 risk factors: hypertension (≥130 mm Hg over ≥85 mm Hg), elevated triglycerides (≥150 mg/dL), low HDL cholesterol (<40 mg/dL for men, <50 mg/dL for women), fasting glucose ≥110 mg/dL, abdominal obesity (BMI ≥28.9 kg/m2 for men and ≥24.9 kg/m2 for women).
Treatment of either high LDL-cholesterol/non-HDL-cholesterol or hypertriglyceridemia can include the following ARV changes: Zidovudine/Stavudine to Abacavir or Tenofovir; Abacavir to Tenofovir; boosted protease inhibitor to unboosted protease inhibitor; any protease inhibitor to Efavirenz or Nevirapine; Efavirenz to Nevirapine; boosted Indinavir or Lopinavir to boosted Darunavir, Atazanavir, fos-Amprenavir, or Saquinavir/Fortovase.