HIV Patients Have More Heart Disease Risk Factors

A new study by French investigators says HIV patients have a higher risk of common coronary heart disease risk factors.

Dr. Genevieve Chene, from Universite Victor Segalen Bordeaux 2 in France, and colleagues evaluated the risk factors for cardiovascular disease in 223 HIV-infected patients who were treated with a drug regimen containing a protease inhibitor. These patients were compared with 527 patients in the general population who were not HIV-infected. All subjects were ages 35 to 44.

The HIV-infected men were more likely to smoke, have a higher waist-to-hip ratio, and a higher triglyceride level than the men who were not HIV-infected. Average HDL "good" cholesterol and frequency of high blood pressure were lower among HIV- infected men. Similar trends were seen among HIV-infected women, but they had higher total cholesterol levels than did women in the comparison group.

The researchers reported that the estimated five-year risk of developing coronary heart disease was 20 percent higher than the general population among HIV-infected men, and 59 percent higher among HIV-infected women. However, a significant percentage of the increased risk -- 65 percent among men, and 29 percent among women -- could be attributed to the higher smoking rates.

Similar trends were found in a group of 45- to 54-year-old men with HIV. This group showed a 22 percent higher risk of coronary heart disease than the comparison group.

"Risk assessment for cardiovascular disease should be a part of routine HIV care," the researchers wrote. "This should include not only laboratory abnormalities but also assessment of smoking habits, exercise activity, and family history of cardiovascular disease."

"Although absolute coronary heart disease risk remains low in HIV-infected patients treated by antiretrovirals, smoking cessation should seriously be considered," Chene said. Abnormal cholesterol levels "only marginally account for the increased risk in this population compared to uninfected patients," she said.

"HIV-infected patients should be aware that they have, on average, a slightly higher risk of coronary heart disease," Chene said.

The full report, "Risk Factors for Coronary Heart Disease in Patients Treated for Human Immunodeficiency Virus Infection Compared with the General Population," was published in Clinical Infectious Diseases (2003;37;(2):292-298).

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