December #97 : HAART to Heart - by Charlotte Huff

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Born Again

Knowing When to Stop

The Divine Miss Em


Cocaine & Heroin

Crystal Meth

Harm Reduction


Recovery Rooms


A for Africa


WHO’s on First

Dying for ADAP


Bombing Gilead

Pos & Neg

Wishful Thinking

Unwrapper’s Delight

Study Hell

Tech Talk


Diarrhea Diary

HAART to Heart

Eradication II?


Breaks: What’s Up?

Safe Spliffs

Slumber Party

Bone Loss

Gimme Shelter


IRSA’s Rochelle advises HIVer refugees:

Editor's Letter


Sale of a Lifetime

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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December 2003

HAART to Heart

by Charlotte Huff

Cardio concern tops docs’ risk list

Three-quarters of docs think that HIVers face increased heart-disease risk, finds an August survey by the International Association of Physicians in AIDS Care (IAPAC). Nearly half (43 percent) of the 143 doctors said they would first recommend lifestyle changes (exercise, diet, no smoking) to HIVers with questionable heart health. Others would prescribe lipid-lowering meds (27 percent) or switch HIV drugs (5 percent). One in four didn’t report recommending any intervention.

St. Louis’ Judith Aberg, MD, who reviewed the results, says that doctors shouldn’t necessarily let heart worries influence which HIV meds they initially prescribe. Studies haven’t yet determined whether elevated lipids and other heart risks result from HIV, the meds, lifestyle, genetics or just plain aging. Indeed, Aberg says, “I’m going to treat the HIV first. If, then, a patient develops risk factors for heart disease, I’ll deal with those.” But Daniel Skiest, MD, a Dallas HIV specialist, says, “For a while now, I’ve been hesitant to use protease inhibitors up front with my patients. We have plenty of drugs to start a patient on that don’t cause lipid abnormalities.”

Meanwhile, lifestyle changes can help. Of the 431 HIVers also surveyed by IAPAC, 52 percent smoked—twice the national average—but just 49 percent reported concern of cardio risk. Skiest says patients ask more about diarrhea, nausea and body shape changes than heart disease.

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