HIV Res Clin Pract. 2026 Dec 31;27(1):2746807. doi: 10.1080/25787489.2026.2746807. Epub 2026 Oct 23.
ABSTRACT
INTRODUCTION: Cardiometabolic disease has been studied in people with HIV, but evidence focused on people with HIV and obesity remains limited. This study assessed atherosclerotic cardiovascular disease, metabolic abnormalities, markers of inflammation, and cardiovascular risk scores among people with HIV and obesity.
METHODS: We conducted an observational, cross-sectional study in clinically stable people with HIV aged ≥35 years and BMI >30 kg/m² in Lima-Callao, Peru, in 2024.
RESULTS: Participants enroled were 126; 77.7% were male, mean age was 50.6 years, mean time on antiretroviral therapy (ART) was 12.4 years, mean CD4 count was 759.8 cells/µL, and 97.6% had HIV-RNA <200 copies/µL. Mean BMI was 34.0. Clinical cardiovascular disease history was uncommon (2.4%); however, carotid Doppler ultrasound showed atherosclerotic changes in 34.4% (increased CIMT or carotid plaque), which associated with older age and longer time of ART. Abnormal glucose metabolism was identified in 89.7%, dyslipidemia in 82.5%, metabolic syndrome in 50.8%, elevated inflammatory markers in 28.2%, and low apolipoprotein A1 in 22.6%. Only 8.1% had normal findings across all evaluations. High cardiovascular risk was observed in 19.4% by Framingham, 9.4% by ACC/AHA, and 75.4% by HIV-CARDIO-PREDICT score.
CONCLUSIONS: This population of middle-aged, clinically stable people with HIV and obesity presented substantial burden of subclinical atherosclerosis and metabolic abnormalities despite low reported cardiovascular disease history. Cardiovascular risk estimates varied substantially across scores, with an HIV-specific score identifying a much higher proportion of patients as high risk than general-population scores. Targeted evaluation and timely preventive management may help reduce cardiometabolic complications.
PMID:42912411 | DOI:10.1080/25787489.2026.2746807