Living with HIV is associated with about a twofold increased risk of heart attack, also known as acute myocardial infarction (AMI), according to a new systematic review and meta-analysis.


Previous research has established that HIV is associated with about a doubled risk of cardiovascular disease (CVD) overall. Recently, researchers have increasingly sought to parse that finding according to various CVD subcategories. For example, one new study looked at the varying high rates of cardiac dysfunction among people with the virus.


Publishing their findings in The Journal of Acquired Immune Deficiency Syndromes, researchers behind the systematic review and meta-analysis analyzed 16 published papers, including five studies that included HIV-positive individuals along with matched HIV-negative control subjects.


The studies’ follow-up time ranged between 1.8 years and 6.3 years. Forty-four percent were conducted in North America and 31% in Europe.


The studies included 248,145 people with HIV, who had a median age of 40 years old; 81% of them were male, and 47% were white. They also included 1.37 million HIV-negative participants, who had a median age of 42 years old; 77% were male, and 50% were white.


The average respective prevalence of various health conditions among those with and without HIV was: high blood pressure, 19% and 15%; smoking, 46% and 49%; irregular lipids, 22% and 18%; and diabetes, 6% and 7%. None of the differences within these pairs were statistically significant, meaning they could have been driven by chance.


Among the HIV-positive participants, the average prevalence of AIDS across all the studies was 27%. Sixty-seven percent of the partcipants with HIV had been exposed to antiretroviral treatment.


In the five cohorts that included people with HIV along with matched HIV-negative individuals, the average rate of heart attack per 1,000 cumulative years of follow-up was 5.0 cases among those with HIV and 2.8 cases among those without the virus. This meant that people with HIV had a 1.96-fold increased risk of heart attack compared with HIV-negative individuals.


Various lifestyle changes, in particular quitting smoking, may lower the risk of CVD among people with HIV. Additionally, the major ongoing clinical trial REPRIEVE is investigating whether the use of statins may mitigate the risk of CVD in the HIV population.


To read the study abstract, click here.