Various HIV antiretrovirals (ARVs) are linked to a raised risk of cardiovascular problems, although the overall risk of such an outcome is still low, aidsmap reports. Publishing their findings in Clinical Infectious Diseases, researchers examined records of 24,510 HIV-positive people enrolled in the Veterans Health Administration Case Registry who received ARV treatment between 1996 and 2009.

The researchers studied the correlation between cardiovascular problems and 15 individual and 23 combinations of ARVs. The study did not include integrase inhibitors or newer non-nucleoside reverse transcriptase inhibitors (NNRTIs, or non-nukes).

During more than 164,000 person-years of follow-up, 934 people in the study cohort experienced a cardiovascular problem, including heart attack, stroke, angioplasty and bypass surgery.

Current (as opposed to cumulative) use of four individual ARVs increased the likelihood of such an outcome by the following factors: Epivir (lamivudine), 1.53-fold; Ziagen (abacavir), 1.5-fold; Sustiva (efavirenz), 1.4-fold; and Retrovir (zidovudine, AZT), 1.41-fold.

Current use of five combination regimens of ARVs increased the likelihood of a cardiovascular problem by the following factors: Ziagen, Epivir and Reyataz (atazanavir), 2.08-fold; Retrovir, Epivir and Reyataz, 2.04-fold; Ziagen, Epivir and Sustiva, 1.94-fold; Retrovir, Ziagen and Sustiva, 1.6-fold; and Retrovir, Ziagen and Epivir, 1.6-fold.

The researchers noted the absolute risk of these cardiovascular troubles remains low. They stress clinicians should first consider a regimen’s likely effectiveness when selecting ARVs for HIV-positive people, and then consider raised cardiovascular risks if there are equivalent regimens to choose from.

To read the aidsmap article, click here.

To read the study abstract, click here.