A common treatment option for HIV patients is associated with an increased risk for a heart attack, according to a new study. However, researchers say the benefit of the treatment outweighs the risk of a heart attack for most patients.
Combination antiretroviral therapy substantially improves the prognosis of HIV-infected patients at risk for AIDS. Before this therapy was available, the annual mortality rate among patients with HIV infection exceeded 20 percent.
In the current research, the mortality rate was 2 percent. While the benefits of combination antiretroviral therapy are clear, there is a concern about the treatment being associated with adverse side effects. These side effects include high cholesterol and triglycerides, insulin resistance and diabetes. These problems can lead to cardiovascular problems.
Researchers in Denmark conducted a study to determine if exposure to combination antiretroviral treatment increases the risk of a heart attack. They looked at information on more than 23,000 patients from 11 previous studies. They collected follow-up information on the patients about their HIV and if they had suffered a heart attack.
Researchers collected data over a period of 36,199 person-years. They found 126 patients had a heart attack. They say the incidence of a heart attack increased with longer exposure to combination antiretroviral therapy. They also say factors such as older age, current or former smoking, previous cardiovascular disease and male sex also increased the risk for a heart attack. Furthermore, a higher cholesterol level, a higher triglyceride level and diabetes were associated with an increased risk for a heart attack.
Investigators conclude combination antiretroviral therapy was independently associated with a 26-percent increase in the rate of a heart attack. However, they point out the risk has to be balanced against the benefits from the antiretroviral treatment. They add that heart disease can take decades to develop, so further follow-up research is needed to determine the absolute risk of cardiovascular disease.