2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Roadmap ▪ Why do we care? ▫ HIV infected vs. uninfected, incidence

▪ MI types in HIV ▫ Universal MI definition ▫ CNICS MI adjudication ▫ Type 1 vs. Type 2 MIs ▪ Why ▪ Other CVD ▪ What do we do? ▫ Risk scores ▪ Summary

Slide34of 43FromHMCrane, MD inNewOrleans, LA, December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

Traditional risk factor modification

• Smoking cessation • Diabetes • Hypertension • Dyslipidemia: lots of rosuvastatin

• ART choices • Risk scores

Slide35of 43FromHMCrane, MD inNewOrleans, LA, December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.

Risk calculators

▪ Framingham Risk Score ▪ AHA/ACC ASCVD Pooled Risk Calculator ▪ D:A:D – includes some ART medications

▪ Most risk predictors developed in the general population, do they predict risk in HIV? Type 1 vs. Type 2 vs. all MI? ▪ Do we want an HIV specific calculator? ▫ Should an HIV specific risk model include inflammatory/immunologic parameters? ▪ Some of the general population models likely underestimate risk in HIV

Slide36of 43FromHMCrane, MD inNewOrleans, LA, December 4-7, 2019, Ryan WhiteHIV/AIDS ProgramCLINICAL CONFERENCE, IAS  USA.