|HIV and exsisting Heart condition
Sep 15, 2005
Im a 26yo, male who's been HIV+ for about two years. Tcell of 470 and a VL of 217,000. I was born with congenital heart desease and have had a pacemaker since I was 4. Im concerned that when it comes time for meds that they might take a toll on my already weak heart. Are there any drugs out there that dont have a big effect on the heart with low side effects?
| Response from Dr. Wohl
None of the HIV drugs have been demonstarted to be directly toxic to the heart. A concern is that some of these drusg can cause an increase in LDL (bad) cholesterol and triglycerides which can lead to atherosclerosis and increased risk for heart attack.
In your case if your cholesterol and triglyceride (i.e. lipid) levels are okay, I would not be too worried about using any particular HIV medications and would treat as I would anyone else. For those with elevated lipid levels before starting HIV meds, especially if they have other risk factors for heart attacks (smoke, family history of early heart disease, diabetes, high blood pressure), I favor using Reyataz (with Norvir) plus another once a day drug such as Truvada or Epzicom.
After starting HIV therapy, monitoring lipids is important. As is keeping to a diet that is low on fats and high on fiber.
We do know that HIV itself can affect the heart. HIV related cardiomyopathy is seen and is difficult to treat. So not being on HIV therapy poses its own risks.
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