Risk of Cardiovascular Disease Among People Living With HIV With Immunological Nonresponse.

BackgroundWe aimed to compare 10-year CVD risk and echocardiographic abnormalities between people living with HIV (PLWH) with immunological non-response (INR) and those with immunological response (IR), and to explore associated factors.MethodsThis cross-sectional study enrolled 260 PLWH with INR and 260 age- and gender-matched PLWH with IR as controls. All participants underwent echocardiography, and their CVD risk was assessed using the Framingham Risk Score (FRS).ResultsCompared to controls, the study group had significantly higher 10-year CVD risk (11.86% vs 9.51%, P<0.05) and a greater prevalence of echocardiographic abnormalities (83.5% vs 74.2%, P=0.01). A longer treatment duration, larger waist circumference, prolonged prothrombin time, lower education level, and carotid plaque presence were all significantly associated with increased CVD risk. Within the study group, age and lower CD19+ levels correlated with a higher rate of echocardiographic abnormalities. An interaction between age and immune reconstitution status on CVD risk was observed (P<0.001).ConclusionsPoor immune reconstitution is associated with increased CVD risk and subclinical cardiac abnormalities, particularly among older PLWH. These findings underscore the need for targeted cardiovascular screening in this vulnerable population.