Cardiovascular Risk Influences Doctors' Treatment Decisions for HIV/AIDS Patients, Survey Says

Smoking, antiretroviral therapy and family history are the top three risk factors for cardiovascular complications among HIV/AIDS patients, according to surveys of physicians and HIV patients published yesterday in a supplement to the Journal of the International Association of Physicians in AIDS Care. Dr. Judith Aberg of the Washington University School of Medicine and colleagues surveyed by fax 143 U.S. doctors, more than 60% of whom see more than 20 HIV patients each week and almost 50% of whom have been treating HIV patients for more than 15 years. The researchers found that although there is not yet definitive scientific evidence that antiretroviral drugs increase the risk of cardiovascular disease, most doctors reported that they believe there is a link, according to an IAPAC release. About 69% of doctors said that more than 25% of their HIV patients who are on antiretroviral regimens have experienced significant increases in their cholesterol levels. More than 90% of doctors named protease inhibitors as a class of antiretroviral drugs that is likely to elevate cholesterol levels, 34% of physicians said that nucleoside reverse transcriptase inhibitors are linked to increased cholesterol levels, and 29% of respondents said that nonnucleoside reverse transcriptase inhibitors were likely to boost cholesterol levels. The survey, titled "Cardiovascular Risk Among HIV-Positive Patients on Antiretroviral Therapy," shows that doctors are making treatment decisions based on cardiovascular risks associated with antiretroviral treatments, according to the release.

Patient Survey
The patient survey, which included the responses of 431 HIV patients, found that almost 50% of participants believe they are at risk of heart disease. The survey, which was hosted by the HIV/AIDS information Web site The Body and funded by pharmaceutical company Boehringer Ingelheim, showed that 52% of participants smoked cigarettes and about 33.8% of those respondents had been smoking for at least 10 years. In comparison, about 23% of the general population smokes cigarettes. IAPAC Vice President and Chief Medical Officer Dr. Basil Vareldzis said, "When treating patients with HIV, physicians must consider all risk factors," adding, "Just as appropriate decisions about smoking are needed to prevent cardiovascular complications, the choice of the right antiretroviral regimen and a healthy lifestyle change can be significant in a patient's long-term cardiovascular health" (IAPAC release, 9/16).

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