Washington Washington. A team of US researchers has found that for people living with HIV, existing risk models underestimate cardiovascular events in both women and black men in high-income countries. According to the new study published in the journal Lancet HIV, HIV-related diseases are the leading cause of morbidity and mortality globally, posing a particularly significant risk to people living with HIV (PWH).
Previous studies have raised questions about whether these commonly used prediction models perform well among people living with HIV, and what these scores mean for PWH in low- and middle-income countries (LMICs). There is still a gap in understanding this.
Researchers at Massachusetts General Hospital, a founding member of the Mass General Brigham Healthcare System, collaborated with an international team of investigators to conduct a study to evaluate how well existing methods predict cardiovascular outcomes in a global population living with HIV. How well atherosclerotic cardiovascular disease (ASCVD) risk estimates can be used.
Their prospective cohort study used data from the Randomized Trial to Prevent Vascular Events in HIV (REPREVE) to analyze individuals living with HIV from low-, middle- and high-income countries across multiple continents. The researchers found that for those included in Reprieve, current risk models underestimated cardiovascular events in both women and black men in high-income countries (HICs), whereas cardiovascular events for all PWH in LMICs Overestimated incidents.
“These findings allow researchers to fine-tune heart disease prediction models for people living with HIV,” said Patrice Desvigne-Nikens, a medical officer at the National Heart, Lung, and Blood Institute (NHLBI).
“Assessing the accuracy of these predictions in subgroups of the population is possible due to carefully developed outreach and enrolling a diverse study population – one that represents all people at risk,” Desvigne-Nikens said. According to Steven Grinspoon, MD, chief of the Massachusetts General Hospital Metabolism Unit in the Department of Medicine's Division of Endocrinology, this study underscores the need for nuanced, region-specific, and population-specific CVD prediction models that accurately predict cardiovascular risk for PWH. This includes people living in LMICs.
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