Sudden cardiac death and myocardial fibrosis, determined by autopsy, in persons with HIV
New England Journal of Medicine — Tseng ZH, Moffatt E, Kim A, et al. | June 18, 2021
Researchers aimed at establishing the incidence of sudden cardiac death and sudden death caused by arrhythmia, as determined by autopsy, in persons with human immunodeficiency virus (HIV) infection. All new deaths due to out-of-hospital cardiac arrest among persons 18 to 90 years of age, with or without known HIV infection, between February 1, 2011, and September 16, 2016, were prospectively identified for comprehensive autopsy and toxicologic and histologic testing. Among persons with known HIV infection vs without known HIV infection, observed incidence rates of presumed sudden cardiac death were 53.3 deaths per 100,000 person-years and 23.7 deaths per 100,000 person-years among persons, respectively; observed incidence rates of sudden death caused by arrhythmia were 25.0 and 13.3 deaths per 100,000 person-years, respectively. This postmortem study suggests higher rates of presumed sudden cardiac death and myocardial fibrosis among HIV-positive persons relative to those without known HIV infection. Occult drug overdose was identified to be linked with one third of apparent sudden cardiac deaths in HIV-positive persons.