Out-of-Hospital Cardiac Arrest in Individuals With Human Immunodeficiency Virus: A Nationwide Population-Based Cohort Study.

Background: Little data exist on the risk and outcomes of out-of-hospital cardiac arrest (OHCA) in people with HIV (PWH). We aimed to describe OHCA in PWH as compared with the general population in terms of incidence, characteristics, and survival.
Methods: This nationwide study assessed all individuals aged 18-85 years between 2001 and 2019 in Denmark. The cumulative incidence of OHCA was computed using cause-specific Cox models accounting for competing risk of death.
Results: Among 6 565 309 individuals, 6 925 (median age: 36; interquartile range [IQR]: 28-44 y; 74% males) were infected at some point with HIV. The incidence of OHCA was 149 (95% CI: 123-180)/100 000 person-years in PWH versus 64 (95% CI: 64-65)/100 000 person-years in people without HIV (P < .001). Age at the time of cardiac arrest was 52 (IQR: 44-61) years in PWH versus 69 (IQR: 59-77) years in individuals without HIV (P < .001). In a multivariable model adjusted for age, sex, hypertension, diabetes, heart failure, ischemic heart disease, atrial fibrillation, chronic obstructive pulmonary disease, cancer, and renal failure, PWH had a 2-fold higher risk of OHCA (hazard ratio: 2.84; 95% CI: 2.36-3.43; P < .001). Thirty-day mortality (89% vs 88%; P = .80) was comparable to individuals without HIV.
Conclusions: HIV is an independent risk factor for OHCA, and those who experience OHCA with HIV are much younger than those without HIV. Almost 90% of PWH died 1 month after OHCA. Further research should strive to find out how to reduce OHCA occurrence in this population.
Competing Interests: Potential conflicts of interest. C. T.-P. reports a grant for a randomized study from Bayer and a grant for epidemiological study from Novo Nordisk. P. E. W. reports an institutional travel grant from Medtronic. J. T.-H. reports project support from the Novo Nordisk Foundation (Tandem Programme no. 31634) and from the John and Birth Meyer Foundation and consulting fees from Johnson and Johnson, Microport, Cytokinetics, and Leo Pharma (paid to the author). C. J. H. reports travel grant support from Medtronic outside the scope of this work. T. B. reports unrestricted institutional grants from Novo Nordisk Foundation, Simonsen Foundation, Lundbeck Foundation, Kai Foundation, Erik and Susanna Olesen's Charitable Fund, GSK, and Pfizer; grants or contracts from Boehringer Ingelheim, MSD, Pentabase, Roche, Novartis, Kancera AB, Janssen, and AstraZeneca; consulting fees from GSK and Pfizer; honoraria for lectures from GSK, Pfizer, Gilead Sciences, Boehringer Ingelheim, Abbvie, and AstraZeneca; advisory board participation with GSK, Gilead Sciences, MSD, Pentabase, Janssen, and AstraZeneca; and receipt of donated trial medication (baricitinib) from Eli Lilly. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
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