Study: HIV Patients Face Heart-Disease Risk

Researchers reported Monday that HIV patients have a sharply higher risk of atherosclerosis -- clogging and hardening of arteries -- and the disease appears to progress quickly. "In the HIV patients, the extent of atherosclerosis was associated with classic cardiac risk factors such as age, cholesterol levels, cigarette smoking and high blood pressure," said Dr. Priscilla Hsue, assistant professor of medicine at University of California-San Francisco.

Hsue and colleagues studied 148 HIV patients, who were on average 45 years old, infected for 11 years, and undergoing treatment with drug cocktails including protease inhibitors for 3.3 years. Researchers used ultrasound to measure the thickness of the carotid arteries. Thickness of this artery is an indication of atherosclerosis.

The average carotid was significantly thicker in HIV patients than among the 63 age- and gender-matched healthy HIV-negative patients. Buildup of fatty plaque was found in 45 percent of HIV patients compared with 24 percent of non-infected patients. A year later, the arteries of some HIV patients had grown thicker, and the rate of thickening was more rapid than in HIV-negative patients.

Drug cocktails used to treat HIV can have side effects including raised cholesterol and changes to metabolism. HIV infection itself could be a cause, said Hsue, because those patients with the most damaged immune systems had the worst atherosclerosis.

"Our finding suggests that it would be reasonable to consider HIV infection a cardiac risk factor," Hsue said. "Other risk factors, such as high cholesterol and high blood pressure, need to be aggressively treated in HIV patients -- even if it means changes in their HIV medications to control cholesterol levels," she said.

The full study, "Progression of Atherosclerosis as Assessed by Carotid Intima-Media Thickness in Patients with HIV Infection," appeared in the American Heart Association's journal Circulation (2004; doi:10.1161/01.CIR.0000124480.32233.8A).

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