HIV, cocaine use, and Hepatitis C virus

Gregory M. Lucas, Mohamed G. Atta, Derek M. Fine, Allison M. Mcfall, Michelle M. Estrella, Katie Zook, James H. Stein

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objective - We assessed cross-sectional and longitudinal associations of 3 nontraditional cardiovascular disease risk factors - HIV, cocaine use, and chronic hepatitis C virus infection - with 3 validated markers of subclinical cardiovascular disease: carotid artery plaque, albuminuria, and aortic pulse wave velocity in a well-characterized cohort. Approach and Results - We measured carotid plaque at baseline and after 24 months, urine albumin/creatinine ratio every 6 months, and pulse wave velocity annually for up to 36 months in a predominantly black cohort of 292 participants (100 HIV negative and 192 HIV positive). Thirty-nine percent had chronic hepatitis C virus infection and 20%, 28%, and 52% were never, past, and current cocaine users, respectively. Sixteen percent, 47%, and 64% of those with none, 1 or 2, or all 3 nontraditional risk factors had ≥2 abnormal cardiovascular disease risk markers (P=0.001). In fully adjusted models that included all 3 nontraditional risk factors, HIV infection was independently associated with carotid plaque progression (increase in the number of anatomic segments with plaque), albuminuria (albumin-creatinine ratio >30 mg/g), albuminuria progression (doubling of albumin-creatinine ratio from baseline to a value >30 mg/g), and pulse wave velocity. Cocaine use was associated with an ≈3-fold higher odds of carotid plaque at baseline, and hepatitis C virus infection was significantly associated with a higher risk of carotid plaque progression. Conclusions - These results suggest that HIV infection, cocaine use, and hepatitis C virus infection are important nontraditional risk factors for cardiovascular disease and highlight the need to understand the distinct and overlapping mechanisms of the associations.

Original languageEnglish (US)
Pages (from-to)2100-2107
Number of pages8
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number10
StatePublished - Oct 1 2016


  • HIV infections
  • cocaine
  • kidney
  • pulse wave analysis
  • ultrasonography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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