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Should HIV be routinely screened during ACS admission? Results from a cohort of over 3,000 consecutive patients
Session:
Posters - E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Speaker:
Marco de Campos Beringuilho
Congress:
CPC 2021
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Marco Beringuilho; b. Lima; m. Santos; a. Jesus; m. Passos; c. Monteiro; m. Nedio; s. Baptista; p. Abreu; c. Morais
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction</strong>: People living with HIV (PLHIV) experience higher cardiovascular (CV) risk compared to uninfected population. Although the national DGS norm 058/2011 suggests screening for HIV in people aged 18-64 years, it is unclear whether it is adequate to screen people with coronary acute syndrome (ACS) for HIV infection. There are no international guidelines regarding this topic. The goals of this study were 1) to determine the prevalence of known HIV infection in patients which have undergone coronary angiography due to ACS and 2) compare their characteristics with a general ACS population, in order to support informed decision-making regarding systematic screening.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods:</strong> The authors did a retrospective cohort study in a hospital which serves an urban population of about 600.000 inhabitants with an estimated prevalence of HIV of 0.7%<strong>.</strong> In our center, all PLHIV are followed in a specific consultation, all patients undergoing coronary angiography are included in a prospective database, and a prospective database for new positive HIV serology is kept. The cross-reference of databases allowed the calculation of the prevalence of HIV infection among patients with SCA. Patients are not routinely screened for HIV at our center during ACS admission. The characteristics of the ACS with and without known HIV infection was compared with Qui-square testing. Data is presented as median (interquartile range). Mann-Whitney and Chi-square statistics were used.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results</strong>: From January 2011 to June 2020, 3,078 patients undergone coronary angiography for ACS; age 63 (53-74) years, 69.7% male. In this period, n=22 ACS patients had a diagnosis of HIV, determining a prevalence of 0.7%; age 53 (48-62) years, 90.9% male. HIV patients were significantly younger (p<0.05). Regarding HIV infection, 3 patients were infected with HIV-2, 1 patient co-infected with HIV-1 and HIV-2 and the remaining 18 with HIV-1. No difference in cardiovascular risk factors was found between the infected and non-infected population is displayed in Table 1. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion:</strong> To the best of our knowledge, this was one of the few studies to assess the prevalence of HIV infection in people with ACS. A prevalence of 0.7%, equal to the estimated prevalence in the area of influence of our hospital, does not favor the systematic screening of HIV in patients admitted for ACS. Nevertheless, these data may underestimate HIV prevalence since routine screening is not performed and patients with HIV followed in other institutions were not detected. Since HIV patients were significantly younger, the present data suggests for systematic screening according to the DGS norm (18-64 years) until multicentric data is available.</span></span></span></p>
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