Abstract 11142: Association of Age, Race, and HIV Disease Severity with Incident Atrial Fibrillation in HIV-Infected Persons

Abstract

Background- Cardiovascular disease is common in HIV-infected persons; however, the most common cardiac arrhythmia, atrial fibrillation (AF), has not been well-studied in this population. We investigated the associations of traditional demographic risk factors and longitudinal measures of HIV disease severity with risk of incident AF in a contemporary cohort of HIV-infected individuals.

Methods and Results- We studied a national sample of 30,533 HIV-infected veterans followed in the Veterans Affairs HIV Clinical Case Registry from 1996-2011. Using proportional-hazards regression for multivariable analysis, we examined the independent associations of age, race, CD4+ cell count, and viral load with the outcome of incident AF. Over a median follow-up of 6.75 years, 780 (2.55%) patients developed AF. After multivariable adjustment for potential confounders, patients ≥65 years of age had an 8-fold greater risk of AF compared to patients <35 years of age (hazard ratio [HR], 7.9; 95% confidence interval [CI], 5.1-12.3; p<0.001). Blacks had lower risk of AF than Whites (HR, 0.6; 95% CI, 0.5-0.7; p<0.001). A CD4+ cell count <200 cells/mm³ compared to >350 cells/mm³ was associated with a greater risk of AF (HR, 1.4; 95% CI, 1.1-1.8; p=0.018), as was a viral load of >100,000 copies/mL compared to <500 copies/mL (HR, 1.7; 95% CI, 1.2-2.4; p=0.002) [Table 1].

Conclusions- In a large HIV-infected cohort, traditional demographic risk factors of older age and White race as well as markers of HIV severity represented by low CD4+ cell count and high viral load were independently associated with development of AF.