Association of Infection with Chronic Hepatitis C Virus and Myocardial Infarction in People Living with HIV in the United States.

We examined the association between HCV and MI in the Centers for Acquired Immunodeficiency Syndrome Research Network of Integrated Clinical Systems, a multi-center clinical cohort of PLWH. MIs were centrally adjudicated and categorized by type using the Universal MI definition. We estimated the association between chronic HCV (RNA+) and time to MI adjusting for demographic characteristics, cardiovascular risk factors, clinical characteristics and history of injecting drug use. Among 23,407 PLWH aged ≥18, there were 336 T1MI and 330 T2MI during a median of 4.7 years of follow-up during 1998 through 2016. HCV was associated with a 46% greater risk of T2MI (adjusted hazard ratio (aHR) 1.46, 95% CI: 1.09, 1.97) but not T1MI (aHR 0.87, 95% CI: 0.58, 1.29). In an exploratory cause-specific analysis of T2MI, HCV was associated with a 2-fold greater risk of T2MI attributed to sepsis (aHR 2.01, 95% CI: 1.25, 3.24). Extrahepatic manifestations of HCV in this high-risk population are an important area for continued research. PMID: 31712804 [PubMed - as supplied by publisher]
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research

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By HANS DUVEFELT, MD Many patients make this or similar requests, especially in January it seems. This phenomenon has its roots in two things. The first is the common misconception that random blood test abnormalities are more likely early warning signs of disease than statistical or biochemical aberrances and false alarms. The other is the perverse policy of many insurance companies to cover physicals and screening tests with zero copay but to apply deductibles and copays for people who need tests or services because they are sick. It is crazy to financially penalize a person with chest pain for going to the ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Education Medical Practice Physicians Primary Care blood tests Hans Duvefelt Labs Source Type: blogs
Background: Insomnia is associated with increased cardiovascular disease (CVD) risk in the general population and is highly prevalent in people with HIV. The CVD risk conferred by insomnia in the HIV population is unknown. Methods: Using the Veterans Aging Cohort Study Survey Cohort, insomnia symptoms were measured and dummy coded with the item, “Difficulty falling or staying asleep?” (5-point scale from no difficulty to bothers a lot). Incident CVD event ICD-9 codes (acute myocardial infarction, stroke, or coronary artery revascularization) were identified with the Department of Veterans Affairs (VA) and ...
Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - Category: Infectious Diseases Tags: Clinical Science Source Type: research
Abstract There appears to be an associative link between chronic hepatitis C (CHC) and cardiovascular diseases (CVDs). However, the exact nature of the relationship between CHC and CVDs has not been elucidated. We investigated the presence of CVDs and the clinical and laboratory alterations associated with these diseases in CHC patients. Twenty-six CHC patients, 35 individuals with atherosclerosis (Athero) and 27 healthy individuals were examined for risk factors for CVD, lipid profile, atherogenic risk indexes, and insulin resistance (IR). Cardiac biomarkers and the chemokines and cytokines involved in atheroscle...
Source: Cytokine - Category: Molecular Biology Authors: Tags: Cytokine Source Type: research
The objective of this study was to estimate the population attributable fractions (PAFs) of preventable or modifiable HIV-related and traditional risk factors for non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes.MethodsWe included participants receiving care in academic and community-based outpatient HIV clinical cohorts in the USA and Canada from Jan 1, 2000, to Dec 31, 2014, who contributed to the North American AIDS Cohort Collaboration on Research and Design and who had validated non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, or ...
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research
As an observer, it can be difficult to find out what ’s happening with value-based contracts (VBCs). The fanfare that accompanies the announcement of a deal invariably gives way to a long period of silence, a good sign if you subscribe to the mantra that no news is good news, but if you don’t, there is cause for concern.The smattering of reports on the topic suggest that green shoots are emerging. A recent survey of 120 payers conducted by the ORC International and commissioned by Change Healthcare, found that payers reported an average saving in medical costs of 5.6% from VBC strategies with an accompanying 77...
Source: EyeForPharma - Category: Pharmaceuticals Authors: Source Type: news
Acute myocardial infarction and renal dysfunction due to chronic extreme anemia (hemoglobin 2.5 g/dL) in immune thrombocytopenia. Proc (Bayl Univ Med Cent). 2018 Oct;31(4):508-510 Authors: Muenchrath M, Aribindi K, Farnie M, DaSilva-DeAbreu A Abstract Immune thrombocytopenic purpura (ITP) is an acquired thrombocytopenia where autoantibodies are generated against platelet antigens. Primary ITP is often idiopathic, whereas secondary ITP has many potential causes, including drug induced, infection related (human immunodeficiency virus, hepatitis C), leukemias, or autoimmune such as systemic lupus ...
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research
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Source: JAIDS Journal of Acquired Immune Deficiency Syndromes - Category: Infectious Diseases Tags: Clinical Science Source Type: research
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Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
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Source: Liver International - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
Conclusion In patients with compensated HCV-related cirrhosis, Asian ethnic origin, arterial hypertension, smoking and low serum albumin are independent predictive factors of cardiovascular events, while a sustained virological response is associated with a decreased rate of cardiovascular events.
Source: American Heart Journal - Category: Cardiology Source Type: research
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