Adjudicated heart failure in HIV-infected and uninfected men and women

Background HIV is associated with elevated risk of heart failure (HF). Despite poor agreement between automated, administrative code–based HF definitions and physician‐adjudicated HF, no studies have evaluated incident adjudicated HF for people living with HIV (PLWH). Methods and Results We analyzed PLWH and uninfected controls receiving care in an urban medical system from January 1, 2000, to July 12, 2016. Physicians reviewed data from medical records to adjudicate HF diagnoses. We used multivariable‐adjusted Cox models to analyze incident HF for PLWH versus controls and HIV‐related factors associated with incident HF. We also analyzed the performance of automated versus physician‐adjudicated HF definitions. Incident adjudicated HF occurred in 97 of 4640 PLWH (2.1%; mean: 6.8 years to HF) and 55 of 4250 controls (1.3%; mean: 6.7 years to HF; multivariable‐adjusted hazard ratio: 2.10; 95% confidence interval, 1.38–3.21). Among PLWH, higher HIV viral load (hazard ratio per log10 higher time‐updated viral ...