Sudden cardiac death in adults living with HIV: A systematic review
Bibliographic record
Abstract
BACKGROUND: People living with HIV (PLWH) have rising life expectancy, and robust evidence shows they are also at increased risk of cardiovascular disease. However, sudden cardiac death (SCD) for PLWH on antiretroviral therapy (ART) has received little attention. Our systematic review examines the quantitative adult PLWH SCD risk literature with a sub-focus of PLWH on ART. METHODS: We conducted systematic searches of PubMed, Embase, CENTRAL, CINAHL, Scopus, and Clinicaltrials.gov for peer-reviewed population studies using search terms "sudden cardiac death" AND ("HIV" OR "human immunodeficiency virus") until 20 June 2025. Two reviewers analysed papers meeting eligibility criteria for their SCD classification methodology including for, but not limited to, comparability, generalizability, and misclassification biases including using the Newcastle-Ottawa Scale. RESULTS: The eight eligible studies included ~98 436 PLWH and demonstrated that males PLWH experience elevated SCD risk compared to the general population. One study with 97% male participants found a hazard ratio (HR) of 1.14 (95% CI: 1.04-1.25) for PLWH compared to non-PLWH. In another, comparing viral load groups of ≥500 vs < 500 found a HR of 1.33 (95% CI: 1.04-1.71) for PLWH with CD4 ≥ 500 compared to HIV-negative HR of 1.03 (95% CI: 0.90-1.18). An autopsy study's male sex arm found a mortality rate ratio for PLWH compared to a reference of 1.34 (95% CI: 0.62-2.87). CONCLUSIONS: The limited available research provides evidence that while SCD risk for male PLWH is elevated, maintaining HIV-RNA plasma viral load suppression and ≥200 CD4+ cells/mm3 counts (ideally higher) likely lowers the risk of SCD to a rate that is approaching comparability to the general population. The risk of SCD in women living with HIV is still unknown, due to small sample sizes, as the majority of the participants in the PLWH studies were male.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.040 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.007 |
| Bibliometrics | 0.009 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".