Heart Disease More Likely for HIV Drug Users

Thursday at the 10th Conference on Retroviruses and Opportunistic Infections, researchers reported that the risk of a heart attack increases by 26 percent for each year HIV patients remain on antiviral medicines.

Dr. Friis Moller of the Copenhagen HIV Program told the conference that a study of 23,468 HIV-positive European men and women (median age: 39) found that 126 had heart attacks, 36 of which were fatal. While the actual number of heart attacks is relatively small, Moller said that each year the European HIV population is on the medications, risk of individual heart attack increases by 26 percent. The researchers concluded that being on antiretroviral drugs was a greater risk than elevated cholesterol levels - the traditional cause of heart disease.

Numerous other studies of US and European patients also noted sharp increases in cardiovascular diseases. Dr. Uchenna Iloeje of Johns Hopkins School of Medicine followed 6,711 HIV patients for nearly three years and found that 89 patients suffered severe cardiovascular disease, mostly heart attacks. Use of protease inhibitors doubled their cardiac risk -- raising it more than cigarette smoking. Another Hopkins study, which surveyed a Baltimore HIV population, found those on HIV medicines had a ten-fold greater risk of a coronary or stroke compared with their age-matched, uninfected counterparts.

Some scientists used ultrasound techniques for measuring the thickness of HIV patients' arteries to look for atherosclerosis. One US team found no significant differences between age-matched HIV-positive and HIV-negative individuals. But another, led by University of California cardiologist Priscilla Hsue, looked at 22 patients who had been HIV-positive for a median of 11 years, all but one of whom were on antiretroviral drugs for an average of four years. The patients had an average arterial buildup of 0.1mm, "way more," she said, than what is seen in elderly men who have already had heart attacks.

While many researchers blame the antiviral drugs, others are not sure. Dr. Wafaa El-Sadr, head of AIDS treatment for Harlem Hospital, presented data on HIV patients from across America showing that they are typically more obese than average Americans, smoke more, and are more likely to have hypertension and diabetes -- even if they are not on HIV drugs.

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