HIV Treatment Speeds Clogged Arteries
Heart Risks May Present New Health Challenges for HIV Patients
March 17, 2004 -- Surviving HIV may only be part of the battle
for people living with HIV.
A new study shows that the aggressive antiviral therapies that
have been credited for prolonging the lives of people with HIV may also speed
the clogging of their arteries and put their heart health at risk.
The results show that hardening of the arteries, or
atherosclerosis, is more common and progresses more quickly in people being
treated for HIV infection.
Researchers say at the close of 2002, 42 million people
worldwide were infected with HIV, and about 40,000 new cases are reported in
the U.S. each year. The introduction of highly active antiretroviral therapy
(HAART) in the mid- to late 1990s has dramatically reduced death rates due to
But as people with HIV are living longer, this study suggests
that they may face other health risks as a result of prolonged drug
The results appear in today's issue of Circulation: Journal
of the American Heart Association.
HIV Treatment May Be New Heart Risk Factor
"Our finding suggests that it would be reasonable to
consider HIV infection a cardiac risk factor," says researcher Priscilla Y.
Hsue, MD, assistant professor of medicine at the University of California, San
Francisco, in a news release. "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
The study examined 148 people with HIV who had been infected
for 11 years and treated for an average of three years with protease inhibitors
as a part of HAART and compared them with 63 similarly matched healthy
Researchers use ultrasound to measure the thickness of the wall
of the carotid arteries, a standard test used to assess plaque buildup. This
measurement can predict the risks of heart attacks and stroke even after
adjusting for other traditional risk factors that have been linked to heart
disease. They found that the average carotid artery was significantly larger in
HIV patients (0.91 mm) than in the control group (0.71mm).
Areas of plaque buildup were found in 45% of the HIV patients
compared with only 24% of the others.
When researchers followed up with a subgroup of these study
participants a year later, they found the progression of atherosclerosis was
significantly more rapid in the HIV group.
"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," says Hsue. "There were
also indications that HIV infection itself may play a role, since patients with
the lowest CD4 immune cell counts (a marker of immunodeficiency) had the
thickest carotid [artery thickness]."