Cytomegalovirus Antibodies and Coronary Artery Disease in People with HIV: A Cohort Study

People with HIV (PWH) have a high risk of coronary artery disease (CAD). Cytomegalovirus (CMV) co-infection is very common in PWH, but little is known about its association with CAD. We aimed to investigate if CMV IgG serostatus and concentrations are associated with CAD in PWH. From the Copenhagen Comorbidity in HIV Infection (COCOMO) Study we included PWH with coronary CT angiography (CCTA) and quantitative CMV IgG concentration measurements. We measured the stenosis grades and plaque volumes in the coronary vessels. Using multivariable regressions adjusted for traditional CAD risk factors, we investigated if CMV IgG serostatus and concentrations were associated with any atherosclerosis, obstructive CAD, or plaque volumes. We included 620 PWH of whom 586 had positive CMV serostatus, which was not associated with any atherosclerosis, obstructive CAD, or plaque volumes. A doubling of CMV IgG concentrations was associated with any atherosclerosis (OR 1.21 [95% CI: 1.06-1.39]), obstructive CAD (OR 1.31 [95% CI: 1.07-1.59]), and higher total plaque volume (1.56 [95% CI: 1.21-2.01] fold increase), but the association did not remain significant after adjustment for traditional CAD risk factors. This indicates that CMV IgG serostatus and concentrations are not independently associated with prevalent CAD in PWH.