Men living with HIV, in particular those with low CD4 counts, have an elevated risk of heart failure, MedPage Today reports. The researchers who reached this conclusion about a group of veterans believe their findings suggest that treating the virus earlier in the course of infection likely mitigates this risk.
Publishing their findings in JAMA Cardiology, investigators analyzed data on 98,015 members of the Veterans Aging Cohort Study, a third of whom were living with HIV and 97 percent of whom were men. They had an average age of 48 and were enrolled on or after April 2003 and followed through September 2012.
The HIV-negative members of the cohort had higher rates of traditional cardiovascular disease risk factors, while the HIV-positive members had higher rates of nontraditional factors, including hepatitis C virus (HCV). Around three in four of those living with HIV were taking antiretrovirals (ARVs).
During a median seven years of follow-up, the cohort members experienced 2,636 incidents of heart failure, about a third of them in people living with HIV. About a third of the heart failure incidents in the HIV-positive group were what is known as heart failure with preserved ejection fraction (HFpEF) and a bit over a third were heart failure with reduced ejection fraction (HFrEF).
After adjusting the data for various factors, the researchers found that compared with the HIV-negative veterans, the HIV-positive vets had the following degrees of increased risk of the following outcomes: overall heart failure, 41 percent; HFrEF, 61 percent; borderline HFpEF, 37 percent; HFpEF, 21 percent.
The investigators restricted their samples of the overall cohort to just those with high blood pressure who did not abuse alcohol or cocaine and who never smoked and found that the link between the virus and heart failure remained stable. The link between HIV and HFrEF was also similar after the study authors adjusted the data for incidents of heart attack during the study’s follow-up.
Looking at differences in immune health and viral control within the HIV-positive population, the investigators found that those with less than 200 CD4s had a higher risk of overall heart failure, HFpEF, borderline HFpEF and HFrEF compared with those with at least 500 CD4s. Those who began the study with a viral load of 500 or higher had a higher risk of HFrEF compared with those with a baseline viral load below 500.
In an accompanying editorial, researchers wrote that a reasonable conclusion to draw from the study’s findings, as well as those of previous research, is that treating HIV early in the course of infection mitigates the risk of heart failure as well as overall risk of cardiovascular disease.
To read the MedPage Today article, click here.
To read the study abstract, click here.