HIV infection is associated with thoracic and abdominal aort
Little is known about the prevalence of aortic aneurysms among people living with HIV (PLWH). This study investigated whether HIV status is independently associated with having aortic aneurysms. Furthermore, it determined risk factors associated with aortic aneurysms in PLWH.

PLWH aged more than 40 years (n=594) were recruited from the Copenhagen Comorbidity in HIV Infection study and matched for age and sex with uninfected controls (n=1188) from the Copenhagen General Population Study. Aortic dimensions were assessed using contrast enhanced computed tomography. Aortic aneurysms were defined according to the European Society of Cardiology guidelines, i.e. an aortic dilation of more than 50% or an infrarenal aortic diameter of more than 30 mm. Among PLWH and uninfected controls, the median (interquartile range) age was 52 (47–60) and 52 (48–61) and 88% and 90% were male, respectively. It found 46 aneurysms in 42 (7.1%) PLWH and 31 aneurysms in 29 (2.4%) uninfected controls.

PLWH had a significantly higher prevalence of ascending aortic aneurysms and infrarenal aortic aneurysms. In an adjusted model, HIV was independently associated with aortic aneurysms. Within PLWH, obesity and hepatitis B co-infection were associated with aortic aneurysms.

Conclusively, PLWH had four-fold higher odds of aortic aneurysms compared to uninfected controls, and HIV status was independently associated with aortic aneurysms. Among PLWH, age, obesity and hepatitis B co-infection were associated with higher odds of aortic aneurysms. These findings suggest that increased attention to aortic aneurysms in PLWH may be beneficial.