Evidence map›Paper›PMID 29967196›Full record

SynthesisCirculation2018

Global Burden of Atherosclerotic Cardiovascular Disease in People Living With HIV: Systematic Review and Meta-Analysis.

Anoop S V Shah, Dominik Stelzle, Kuan Ken Lee, Eduard J Beck, Shirjel Alam, Sarah Clifford, Chris T Longenecker, Fiona Strachan, Shashwatee Bagchi, William Whiteley and 6 more

2 registry-linked trialsOpen access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Circulation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 557 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
557citing papers in PubMed, 11 pooled it
70.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06784154 recruitingnot on this mapstarted 2024, after this paper: background citation

The Association of Ectopic Fat and Cardiovascular Disease in People Living With HIV and General Populations: A Cross Sectional Analysis

TypeobservationalSponsorUniversity of LiverpoolRan2024 to 2027Enrolled100ConditionsCardiometabolic Syndrome, HivArmsNon-interventional
NCT07662161 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Coronary Artery Calcium Score in HIV Mexican Population (The CACsHIVMex Study)

Typeobservational_patient_registrySponsorInstituto Mexicano del Seguro SocialRan2026 to 2030Enrolled384ConditionsHIV - Human Immunodeficiency VirusArmsSimple coronary CT scan
3 · Its place in the literature

Who cites it

557 citing papers in PubMed, 11 syntheses or guidelines pooled it, 923 citations in OpenAlex.

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  12. Hypertension in a Randomized Trial of Dolutegravir- Versus Efavirenz-Based Antiretroviral Therapy in Pregnant and Postpartum Women with HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
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497 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 7 countries.

Anoop S V ShahBHF Centre for Cardiovascular Science, University of Edinburgh, Scotland (A.S.V.S., K.K.L., S.A., S.C., F.S., D.E.N., N.L.M.).
Dominik StelzleJoint United Nations Programme on HIV/AIDS, Geneva, Switzerland (D.S., E.J.B.).
Kuan Ken LeeBHF Centre for Cardiovascular Science, University of Edinburgh, Scotland (A.S.V.S., K.K.L., S.A., S.C., F.S., D.E.N., N.L.M.).
Eduard J BeckJoint United Nations Programme on HIV/AIDS, Geneva, Switzerland (D.S., E.J.B.).
Shirjel AlamBHF Centre for Cardiovascular Science, University of Edinburgh, Scotland (A.S.V.S., K.K.L., S.A., S.C., F.S., D.E.N., N.L.M.).
Sarah CliffordBHF Centre for Cardiovascular Science, University of Edinburgh, Scotland (A.S.V.S., K.K.L., S.A., S.C., F.S., D.E.N., N.L.M.).
Chris T LongeneckerDivision of Cardiovascular Medicine, Case Western Reserve School of Medicine, Cleveland, OH (C.T.L., S.R.).
Fiona StrachanBHF Centre for Cardiovascular Science, University of Edinburgh, Scotland (A.S.V.S., K.K.L., S.A., S.C., F.S., D.E.N., N.L.M.).
Shashwatee BagchiDivision of Infectious Diseases and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD (S.B., S.K.).
William WhiteleyCentre for Clinical Brain Sciences (W.W.), University of Edinburgh, United Kingdom.
Sanjay RajagopalanDivision of Cardiovascular Medicine, Case Western Reserve School of Medicine, Cleveland, OH (C.T.L., S.R.).
Shyamasundaran KottililDivision of Infectious Diseases and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD (S.B., S.K.).
Harish NairUsher Institute of Population Health Sciences and Informatics, University of Edinburgh, Scotland (A.S.V.S., H.N.).
David E NewbyBHF Centre for Cardiovascular Science, University of Edinburgh, Scotland (A.S.V.S., K.K.L., S.A., S.C., F.S., D.E.N., N.L.M.).
David A McAllisterInstitute of Health and Wellbeing, University of Glasgow, United Kingdom (D.A.M.).
Nicholas L MillsBHF Centre for Cardiovascular Science, University of Edinburgh, Scotland (A.S.V.S., K.K.L., S.A., S.C., F.S., D.E.N., N.L.M.).
Norwegian Womens Public Health Association · NOCase Western Reserve University · USCentre for Global Health Research · CAJoint United Nations Programme on HIV/AIDS · CHUniversity of Maryland, Baltimore · USUniversity of Glasgow · GBWhiteley Clinic · GB

Funding

Elucidating Hepatitis C Infection as a Risk Factor for Coronary Heart Disease in HIV-Infected PatientsK23HL133358 · NHLBI · UNIVERSITY OF MARYLAND BALTIMORE · PI BAGCHI, SHASHWATEE · 2017 to 2021
$955k
British Heart Foundation FS/16/14/32023British Heart Foundation FS/18/25/33454Chief Scientist Office SCAF/17/01Wellcome Trust 201492/Z/16/Z
6 · The paper itself

Abstract

backgroundWith advances in antiretroviral therapy, most deaths in people with HIV are now attributable to noncommunicable illnesses, especially cardiovascular disease. We determine the association between HIV and cardiovascular disease, and estimate the national, regional, and global burden of cardiovascular disease attributable to HIV.

methodsWe conducted a systematic review across 5 databases from inception to August 2016 for longitudinal studies of cardiovascular disease in HIV infection. A random-effects meta-analysis across 80 studies was used to derive the pooled rate and risk of cardiovascular disease in people living with HIV. We then estimated the temporal changes in the population-attributable fraction and disability-adjusted life-years (DALYs) from HIV-associated cardiovascular disease from 1990 to 2015 at a regional and global level. National cardiovascular DALYs associated with HIV for 2015 were derived for 154 of the 193 United Nations member states. The main outcome measure was the pooled estimate of the rate and risk of cardiovascular disease in people living with HIV and the national, regional, and global estimates of DALYs from cardiovascular disease associated with HIV.

resultsIn 793 635 people living with HIV and a total follow-up of 3.5 million person-years, the crude rate of cardiovascular disease was 61.8 (95% CI, 45.8-83.4) per 10 000 person-years. In comparison with individuals without HIV, the risk ratio for cardiovascular disease was 2.16 (95% CI, 1.68-2.77). Over the past 26 years, the global population-attributable fraction from cardiovascular disease attributable to HIV increased from 0.36% (95% CI, 0.21%-0.56%) to 0.92% (95% CI, 0.55%-1.41%), and DALYs increased from 0.74 (95% CI, 0.44-1.16) to 2.57 (95% CI, 1.53-3.92) million. There was marked regional variation with most DALYs lost in sub-Saharan Africa (0.87 million, 95% CI, 0.43-1.70) and the Asia Pacific (0.39 million, 95% CI, 0.23-0.62) regions. The highest population-attributable fraction and burden were observed in Swaziland, Botswana, and Lesotho.

conclusionsPeople living with HIV are twice as likely to develop cardiovascular disease. The global burden of HIV-associated cardiovascular disease has tripled over the past 2 decades and is now responsible for 2.6 million DALYs per annum with the greatest impact in sub-Saharan Africa and the Asia Pacific regions. CLINICAL

trial registrationURL: https://www.crd.york.ac.uk/prospero . Unique identifier: CRD42016048257.

Indexed as

Cost of IllnessGlobal HealthHIV Long-Term SurvivorsAdultAtherosclerosisFemaleHIV InfectionsHumansIncidenceMaleMiddle AgedPrevalencePrognosisRisk AssessmentRisk FactorsTime Factorscardiovascular diseasesglobal burden of diseaseHIVmyocardial infarctionstroke

Identifiers

PMID29967196
PMCPMC6221183
OpenAlexW3025713364

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.