HIV and the aorta

Question

Hi Dr. Henry

My father and brother have both had an aortic dissection. It was fatal to my father but luckily little brother caught it in time and is recovering. My local cardiologist said that since I don't have the normal risk factors of smoking or high blood pressure, he wasn't too worried. I do need to lose some weight, so will work on that. He also said controlled HIV should play no role in this. He has scheduled an "aortic CT scan" for next week along with an ultrasound and blood work (calcium test?). EKG was fine.

Do you agree with his assessment that HIV is irrelevant here? While my CD4 count is still under 200 (but improving), Atripla has worked in keeping the virus undetectable for nearly a year.

Answer

HIV disease has not yet been linked to an increased risk for aortic dissection/aneurysm independent of any association with standard atherosclerosis. With a strong family history a screening X-ray exam seems reasonable (as you mention). Control of HIV infection and addressing other risk factors for cardiac disease may decrease the risk for future severe cardiovascular problems though again aortic dissection/aneurysm usually not on the list of HIV related problems compared to more traditional forms of atherosclerosis. KH