Brief Report: Association of HIV and HCV With Adverse Coronary Artery Phenotypes in Women: Findings From a Cross-Sectional Study

BACKGROUND: HIV and hepatitis C virus (HCV) have each been associated with increased risk of coronary heart disease events. Coronary computed tomography angiography (CCTA) has linked HIV to noncalcified plaque, and HCV to both calcified and noncalcified plaque, but available data come mostly or exclusively from men. METHODS: We performed a cross-sectional study of CCTA in women from the Bronx site of the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study to investigate associations of HIV and HCV status with adverse coronary artery phenotypes, including total plaque, noncalcified plaque, and coronary artery calcium (CAC). RESULTS: Of 79 participants (median age 56 years), 53 were women with HIV (WWHIV) and 16 were women with positive HCV status all but 1 of whom had cleared viremia). On multivariable adjustment, WWHIV had near-significantly higher noncalcified plaque volume extent [RR = 3.53 (0.98, 12.68), P = 0.053] compared with women without HIV, but there were no significant associations of HIV with other coronary phenotypes. Compared with HCV-negative women, HCV-positive women exhibited a significantly higher CAC score [RR = 4.77 (1.44, 15.85), P = 0.010] and near-significantly greater odds of noncalcified plaque [OR = 4.25 (0.97, 18.73), P = 0.055] and total plaque [OR = 4.26 (0.96, 18.87), P = 0.056]. CONCLUSIONS: The present findings support the association of HIV with higher-risk, noncalcified plaque in women, and with a more calcific plaque phenotype in HCV-positive women even after viremic clearance. Although these results require further investigation in larger samples, they underscore the importance of implementing recommended cardiovascular preventive and HCV screening efforts in this vulnerable population.