February 21, 2003
The drugs, including protease inhibitors, have been blamed by doctors and patients for a variety of side effects linked to heart disease and stroke, including insulin resistance, higher levels of bad cholesterol and reduced levels of good cholesterol. Another of the drugs' side effects is lipodystrophy -- a redistribution of fat from the arms, cheeks and around the eyes to the stomach, shoulder blades and the back of the neck. Other problems include blood sugar imbalances and higher levels of C-reactive protein -- linked to increased heart disease -- and increased thickness of the carotid arteries.
But whether the side effects translated to more cardiovascular problems had been unclear. To find out, the researchers, led by Dr. Samuel A. Bozzette of SDVA and others from John Hopkins Bloomberg School of Public Health, examined the records of nearly 37,000 HIV patients treated for HIV at VA facilities nationwide between 1993 and June 2001, the type of AIDS drugs taken, for how long, and whether the patients had any previous vascular disease.
About one-fourth had been treated for conditions associated with increased heart disease, a factor that should have raised the number of vascular deaths, researchers said. They concluded that not only did the overall death rate drop by 75 percent in those patients who were treated, but the number of patients who died or were admitted to the hospital because of heart disease or stroke also declined. "This finding indicates that ... HIV-infected patients have been enormously better off since the advent of highly active antiretroviral therapy," the study said.
San Diego Union Tribune
02.20.03; Cheryl Clark