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HIV Treatment Speeds Clogged Arteries

Heart Risks May Present New Health Challenges for HIV Patients
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WebMD Health News

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 HIV.

But as people with HIV are living longer, this study suggests that they may face other health risks as a result of prolonged drug treatment.

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 levels."

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 adults.

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]."

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