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Keletra & Heart Issues
Mar 7, 2005

Hi, I've used your site for some time now and really appreciate your insight. I have an question regarding Keletra & related heart issues. While I have been HIV+ for 20 years (and fortunate to have high T-cells and undectable viral load), I have watched friends pass on from the disease. However, lately more seem to be related to medication complications. I have a friend going in for a double bypass this week. He's the fourth from last year to this year. All four were taking Keletra. None of them have cardio issues inherent in their families and they were all doing quite well prior to going on Keletra. Has there been any studies regarding the relationship between the use of Keletra and heart problems? I'm aware medications can cause issues for various people. However, this is the most dramatic relationship I've ever seen. Thanks.

Response from Dr. Henry

There have been studies showing that use of HAART can increase the risk of coronary heart disease ranging from 10-25% increase per year of therapy (above a generally low risk in an age matched population). Kaletra raises lipid levels which often need to be targeted in intervention. Stopping smoking, exercise, proper diet, treating high blood presssure--all can impact risk of heart disease (stopping smoking at the top of the list). Heart disease is a major cause of death as people grow older so as HIV infected persons live longer cancer and heart disease become major issues. On a spectrum of risk some persons develop severe coronary heart disease even with low levels of risk factors (? chronic inflammation a factor). Kaletra is an effective drug that has been able to control HIV for long periods of time so it gets linked to situations where patients are experiencing heart disease. It has not been established (but is being looked at ) whether any particular drug has more of a link than others. Also, if the lipid levels are high with Kaletra there are an expanding number of alternative protease inhibitors which may have less an effect on lipids that could be considered depending on the situation. KH

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