Cumulative HIV viremia copy-years and hypertension in people living with HIV.

BACKGROUND: Evidence regarding the association between HIV viral load (VL) and hypertension is inconsistent. In this study, we investigated the relationship using viremia copy-years (VCY), a cumulative measure of HIV plasma viral burden. METHODS: Data were analyzed for 686 PLWH in the Florida Cohort Study who had at least five years of VL data before the baseline. VL data were extracted from Enhanced HIV/AIDS Reporting System (eHARS) and used to define peak VL (pVL), recent VL (rVL), and undetectable VL (uVL: rVL 5.7) for analysis. Hypertension was determined based on hypertension diagnosis from medical records. Multivariable logistic regression was used for association analysis. RESULTS: Of the total sample, 277 (40.4%) participants were hypertensive. Compared to the participants with lowest VCY (<2.7 log10 copy x years/mL), the odds ratios (OR) and 95% confidence interval [95% CI] for hypertension of the remaining four groups, in order, were 1.91 [1.11, 3.29], 1.91 [1.03, 3.53], 2.27 [1.29, 3.99], and 1.25 [0.65, 2.42], respectively, controlling for confounders. The association was independent of pVL, rVL, and uVL, each of which was not statistically significant associations with hypertension. CONCLUSION: Persistent HIV infection is a risk factor for hypertension among PLWH. Information provided by VCY is more effective than single time-point VL measures in investigating HIV infection-hypertension relationship. Findings of this study support the significance of continuous viral suppression in hypertension prevention among PLWH.