January 8, 2010

HIV-Positive Men More Likely to Have Coronary Artery Blockage

HIV-positive men with no known cardiovascular disease (CVD) risk factors were significantly more likely to have serious accumulations of plaque in their coronary artery (atherosclerosis) than HIV-negative men of a similar age, according to a study published in the January 2010 issue of AIDS.

CVD is a growing concern for people living with HIV. This is partly due to the fact that antiretroviral (ARV) therapy has seriously increased the percentage of HIV-positive people living into their 50s and beyond. There is a particular concern in people with HIV, however, because both HIV and some ARV treatments have been found in numerous studies to further increase the risk of CVD in aging adults.

To determine the likelihood of coronary atherosclerosis—which increases the risk of a heart attack and stroke, as well as other forms of CVD—in HIV-positive and HIV-negative men in their 40s, Janet Lo, MD, and her colleagues at Harvard Medical School recruited 78 HIV-positive and 32 HIV-negative men for analysis. Only men without current symptoms or a diagnosis of CVD were allowed in the study. Lo and her colleagues conducted traditional physical exams, interviews with the study participants about their medical history and computed tomography (CT) scans of coronary arteries.

The average age of the participants was about 45, and most were white. HIV-positive men were slightly more likely than HIV-negative men to have a family history of CVD, to have high blood pressure and to have diabetes.

Over all, the presence of coronary atherosclerosis was higher in HIV-positive men than their HIV-negative counterparts. Fifty-nine percent of HIV-positive men had coronary atherosclerosis compared with 34.4 percent of HIV-negative men.

HIV-positive men with coronary atherosclerosis were more likely to be older, to have been HIV positive longer and to have a higher Framingham risk score—a calculation based on age, hypertension and cholesterol levels—than HIV-positive men who did not have coronary atherosclerosis. They also had higher total cholesterol and higher triglycerides. HIV-positive participants with coronary atherosclerosis were no more likely to be on ARV therapy than HIV-positive participants without coronary atherosclerosis, but they were more likely to have immune cells that respond to cytomegalovirus (CMV), a common viral infection.

One finding that surprised and concerned Lo’s team, however, was the fact that 6.5 percent of the HIV-positive men had a high degree of arterial plaque buildup, despite being relatively young—in their 40s—and with no history of CVD.

“Our findings suggest a high prevalence and significant degree of coronary atherosclerosis among young HIV-infected men with a long duration of HIV disease, without any symptoms of cardiac disease or a prior diagnosis of cardiac disease,” the authors write. “Our data highlight the need to address cardiac risk reduction early in the course of HIV disease, before significant subclinical disease accrues and before cardiac events occur.”

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Ron W., broken arrow,oklahomo, 2010-01-13 14:29:14
From 97 to 99 I was seeing a very good doctor in garden grove,Ca. I was on a great regimen and my viral load had dropped from over 2million to undetectable. But noone was keeping an eye on my cholesterol. I moved back home to okla. in 2000 and a few years later I started having chest pains and found my cholst. was at 560, The Crixivan I took had already made me diabetic and now i had a quad. bypass and 6 stents put in, so please monitor this carefully people. and be careful, Bearhugs to all, Ron