Telomere Length, Traditional Risk Factors, HIV-related Factors and Coronary Artery Disease Events in Swiss Persons Living with HIV.

Engel, Tanja; Raffenberg, Marieke; Schoepf, Isabella C; Kootstra, Neeltje A; Reiss, Peter; Thorball, Christian W; Hasse, Barbara; Hirzel, Cédric; Wissel, Kerstin; Roth, Jan A; Bernasconi, Enos; Darling, Katharine E A; Calmy, Alexandra; Fellay, Jacques; Kouyos, Roger D; Günthard, Huldrych F; Ledergerber, Bruno; Tarr, Philip E (2021). Telomere Length, Traditional Risk Factors, HIV-related Factors and Coronary Artery Disease Events in Swiss Persons Living with HIV. Clinical infectious diseases, 73(7), e2070-e2076. Oxford University Press 10.1093/cid/ciaa1034

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Leukocyte telomere length (TL) shortens with age and is associated with coronary artery disease (CAD) events in the general population. Persons living with HIV (PLWH) may have accelerated atherosclerosis and shorter TL than the general population. It is unknown whether TL is associated with CAD in PLWH.


We measured TL by quantitative PCR in white Swiss HIV Cohort Study participants. Cases had a first CAD event during 01.01.2000-31.12.2017. We matched 1-3 PLWH controls without CAD events on sex, age, and observation time. We obtained univariable and multivariable odds ratios (OR) for CAD from conditional logistic regression analyses.


We included 333 cases (median age 54 years; 14% women; 83% with suppressed HIV RNA) and 745 controls. Median time (interquartile range) of TL measurement was 9.4 (5.9-13.8) years prior to CAD event. Compared to the 1st (shortest) TL quintile, participants in the 5th (longest) TL quintile had univariable and multivariable CAD event OR=0.56 (95% confidence interval, 0.35-0.91) and OR=0.54 (0.31-0.96). Multivariable OR for current smoking was 1.93 (1.27-2.92), dyslipidemia OR=1.92 (1.41-2.63), and for recent abacavir, cumulative lopinavir, indinavir, and darunavir exposure was OR=1.82 (1.27-2.59), OR=2.02 (1.34-3.04), OR=3.42 (2.14-5.45), and OR=1.66 (1.00-2.74), respectively. The TL-CAD association remained significant when adjusting only for Framingham risk score, when excluding TL outliers, and when adjusting for CMV-seropositivity, HCV-seropositivity, time spent with detectable HIV viremia, and injection drug use.


In PLWH, TL measured >9 years before, is independently associated with CAD events after adjusting for multiple traditional and HIV-related factors.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Hirzel, Cédric


600 Technology > 610 Medicine & health




Oxford University Press




Annelies Luginbühl

Date Deposited:

23 Dec 2020 14:58

Last Modified:

05 Dec 2022 15:42

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

HIV Infection coronary artery disease leucocyte telomere length multivariable analysis traditional risk factors




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