A group of articles in The Journal of Infectious Diseases describes the impact and prevalence of heart disease and other critical comorbidities on an aging population with HIV, according to a press release from Massachusetts General Hospital.

The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) study has played a key role in helping the health care industry look closer at the disproportionate risk of comorbidities, such as chronic liver and kidney disease, physical function impairment and frailty, premature reproductive aging, and cancer in patients with HIV.

“The release of this initial baseline data from REPRIEVE will help physicians and researchers to better understand the whole person impact of HIV, and ultimately to develop more effective preventions, treatment strategies and guidelines for cardiovascular risk management in this population. In a very real way, co-morbidities are the newest frontier of HIV,” said co-principal investigator of REPRIEVE Steven Grinspoon, MD, in a press release.

REPRIEVE enrolled 7770 participants from 2015 to 2019 across more than 100 clinical research sites in 12 countries and 5 continents, reflective of the ethnic, racial, and gender diversity of the global HIV epidemic. The reported findings, in collaboration with the AIDS Clinical Trials Group, is expected to be public in 2023.

The primary objective of REPRIEVE is to reduce major adverse cardiovascular events in patients with HIV through a cardiac prevention strategy, using pitavastatin calcium, and is attempting to assess non-cardiovascular disease comorbidities, according to the press release.

One of the reports suggests that physical function impairment and pre-frailty are common among middle-aged people with HIV. Additionally, the report indicates that body mass index and physical activity are key modifiable risk factors that may prevent further decline in function with aging among the HIV population.

Another report shows that reproductive aging in middle-aged women with HIV is associated with global burden of disease region of enrollment. New data on the participation of transgender participants and the cardiovascular risk associated with gender-affirming therapy in this population are also reported, according to the press release.

“This initial compilation of data from the landmark REPRIEVE study offers a rich window on the kinds of diseases physicians find themselves treating at a time when the HIV demographic is changing as the result of effective antiretroviral drugs, increasing life expectancies, and the substantial growth of cardiovascular disease and other comorbidities in a still vulnerable population,” Grinspoon said in the press release. “By shedding light for the first time on the magnitude and complexity of the problem, we believe this information and more to follow will play a critical role in developing cardiac prevention strategies along with improved health care for the 37 million people living with HIV globally.”

REFERENCE
Initial data from the landmark REPRIEVE study on HIV and heart disease highlights the multiple health risks among a population that’s living longer. Massachusetts General Hospital. https://www.massgeneral.org/news/press-release/Initial-data-from-the-landmark-reprieve-study-on-hiv-and-heart-disease-highlights-the-multiple-health-risks-among-a-population-thats-living-longer. Published July 10, 2020. Accessed July 20, 2020.