# HIV Status and Incidence and Outcomes of Heart Failure

> **NIH NIH R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2020 · $624,664

## Abstract

PROJECT SUMMARY/ABSTRACT
Heart failure (HF) currently affects approximately 6 million American adults and is associated with a high risk
for premature death, hospitalizations and poorer quality of life. Unlike other cardiovascular diseases such as
acute myocardial infarction that has declined over time, the burden of HF is projected to increase by almost
50% by 2030. HIV-infected patients may be particularly vulnerable to developing HF, given the known higher
risk of myocardial infarction and higher prevalence of vascular risk factors, antiretroviral therapy (ART)-related
adverse effects, and direct effects of HIV infection, including immunodeficiency and inflammation. However, to
date, HF has received very limited attention in this population. Yet, with increased survival for HIV-infected
patients in the ART era, resulting in near-normal life spans, HIV-infected persons are now subject to greater
risk for common age-related comorbidities, with particular concern for serious conditions such as HF. To
address these key knowledge gaps, this application responds to PAR-15-280 (Multidisciplinary Studies of
HIV/AIDS and Aging [R01]). This study aims to identify optimal strategies for both primary prevention of HF
and improving outcomes in HIV-infected patients who develop HF. We will conduct this research within the
three largest Kaiser Permanente (KP) health systems in the Cardiovascular Research Network's (CVRN) Heart
Failure consortium, which has a long history of studying HF epidemiology, management and outcomes. The
CVRN and KP are uniquely suited for the proposed study given the long-standing HIV registries, standardized
Virtual Data Warehouse, comprehensive electronic medical record, and ability to identify carefully-matched
HIV-uninfected controls from the same source population. We anticipate identifying 39,000 HIV-infected and
390,000 high-dimensional propensity-matched HIV-uninfected adults, an unprecedented sample size for a
study on this topic. We propose to achieve three complementary specific aims. The first aim is to characterize
the association of HIV status with the incidence of HF and HF type (reduced versus preserved ejection
fraction). The second aim will investigate clinically meaningful treatment strategies for the prevention of HF and
HF types in HIV-infected adults, focusing on the effect of composition and adherence to ART and long-term
immunosuppression and viral replication using state-of-the-art causal modeling approaches to emulate the
results of randomized trials. Finally, among new HF cases that develop among HIV-infected and HIV-
uninfected adults, the third aim will examine the association of HIV status on HF-related hospitalizations and
death. Given the negative impact of HF on individuals, families and health systems, we expect these results to
help inform key gaps in knowledge regarding HF in HIV-infected patients, including improving primary and
secondary prevention strategies in this aging population.

## Key facts

- **NIH application ID:** 9839653
- **Project number:** 5R01HL132640-04
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Alan S Go
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $624,664
- **Award type:** 5
- **Project period:** 2016-12-15 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9839653

## Citation

> US National Institutes of Health, RePORTER application 9839653, HIV Status and Incidence and Outcomes of Heart Failure (5R01HL132640-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9839653. Licensed CC0.

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