Aging & Longevity

The additive value of coronary calcium in identifying cardiovascular risk in ageing people with HIV.

Varadarajan M, Byrne R, et al. • AIDS (London, England) • 2026

PubMed 42657612 DOI 10.1097/QAD.0000000000004514

TL;DR

Coronary artery calcium scores better predicted adverse cardiovascular outcomes than Q-risk scores in people with HIV, and advanced imaging research may improve major cardiovascular risk prediction in people ageing with HIV.

Key Findings

Results

Coronary artery calcium scores (CACS) better predicted adverse outcomes than Q-risk scores in people with HIV.

Adverse outcomes assessed included major adverse cardiovascular events (MACE), death, and heart failure.
Data were collected on 779 individuals with HIV who underwent CACS scans.
The median age of the study population was 55 years.
Q-risk scores, a standard cardiovascular risk prediction tool, were used as the comparator.

Background

HIV is associated with elevated coronary artery calcium scores.

The study population consisted of 779 individuals with HIV who underwent CACS scans.
The paper notes that HIV is associated with elevated CACS, consistent with prior literature.
Risk factors beyond smoking and diabetes contributing to elevated CACS in people with HIV are not well established.

Background

Smoking and diabetes are recognized risk factors for elevated CACS in people with HIV, but additional risk factors specific to this population remain poorly characterized.

The abstract explicitly states that 'risk factors beyond smoking and diabetes are not well established' in the context of HIV and elevated CACS.
The study aimed to identify cardiovascular risk factors in an ageing HIV population.
The median age of participants was 55 years, reflecting focus on an ageing HIV cohort.

Conclusions

Advanced imaging research using CACS may improve major cardiovascular risk prediction in people ageing with HIV.

Standard risk prediction tools such as Q-risk scores were found to be inferior to CACS in this population.
The study sample included 779 HIV-positive individuals who underwent CACS scanning.
The authors conclude that advanced imaging research 'may improve major cardiovascular risk prediction in people ageing with HIV.'

What This Means

This research suggests that a heart scan measuring calcium buildup in the coronary arteries (called a coronary artery calcium score, or CACS) is better at predicting serious heart-related problems in people living with HIV than standard risk calculators used in clinical practice. The study followed 779 people with HIV, with an average age of 55, and found that those with higher calcium scores were more likely to experience major cardiovascular events, heart failure, or death compared to what standard risk tools like Q-risk predicted. People living with HIV appear to have higher levels of coronary calcium than people without HIV, but the reasons beyond well-known factors like smoking and diabetes are not fully understood. This study highlights a gap in current cardiovascular risk assessment for this population, suggesting that standard tools may underestimate their true risk. This research suggests that incorporating coronary artery calcium scanning into the care of ageing people with HIV could help doctors identify those at highest risk of heart disease more accurately. As people with HIV are living longer due to effective treatments, managing cardiovascular risk is becoming increasingly important, and better risk prediction tools could lead to more targeted preventive care for this group.

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Citation

Varadarajan M, Byrne R, Al-Hussaini A, Halliday B, Nicol E, Nelson M, et al.. (2026). The additive value of coronary calcium in identifying cardiovascular risk in ageing people with HIV.. AIDS (London, England). https://doi.org/10.1097/QAD.0000000000004514

Key Findings

What This Means

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