Prevalence of cardiovascular risk factors in Spanish HIV-1-infected male inmates

Purpose of the study

HIV-1-infected inmates have an increased prevalence of some particular comorbidities. However, the cardiovascular risk(CVR) of this population has rarely been evaluated.

Methods

Cross-sectional study carried out among 216 male HIV-1 patients in prison. Patients were stratified according to age(<34, 35-39, 40-44, 45-49, 50-54 and >55 years old, respectively)and their CVR was assessed by Framingham(FRAM) equation. The prevalence of some further risk factors was also evaluated: time on antiretroviral therapy, nadir CD4 count, maximum viral load(VL), time on undetectable VL, HCV-coinfection, and cocaine use.

Results

Patients median age was 41 years(36-46), their median CD4 count was 386(240- 549)cells, 68% had an undetectable(<50 c/mL)VL, median nadir CD4 count was 207(104-315)cells, and 48% of them had a nadir CD4 count <200 cells. HCV-coinfection prevalence was 94%, cocaine consumption prevalence was 93.1%, and 54.2% of them were intravenous cocaine users. The FRAM 10-years CVR score among subjects studied was 5.88%. Figure 1 and Table 1.

Figure 1

CVR stratified by age group.

Table 1 Cardiovascular risk factors prevalence stratified by age group.

Conclusions

Using the FRAM scores, the median CVR of developing a cardiac event at 10 years in a population of Spanish HIV-1-infected inmate males is 5.88%. Of them, 5.1% have a high CVR, and are evenly distributed among age groups. The smoking prevalence is significantly higher than in non-inmate HIV-1 infected individuals, and is so high that it does not allow CVR differences among age groups. HCV-coinfection, cocaine use, and parenteral cocaine consumption were not associated with an increased CVR in our population. On the other hand, a lower nadir CD4 count was associated with high rates of CVR, thus supporting an earlier initiation of ARV therapy in HIV-1 infected males in the prison environment.