May 2, 2011
HIV infection is a risk factor for heart failure, even for patients without a previous history of coronary disease, a new study finds. Higher viral loads were associated with a higher risk of heart failure.
The US study involved 8,486 participants, including 28.2 percent who were HIV-infected, with a median age of 48 years. During follow-up of a median 7.3 years, 286 people developed heart failure, with 7.12 cases per 1,000 person-years among those with HIV and 4.82 for controls, adjusting for age, race and ethnicity.
Adjusted for traditional risk factors, the hazard ratio for heart failure among those with HIV was 1.81. This persisted even among those with no prior history of coronary heart disease or alcohol abuse or dependence. Compared with controls, those with HIV with a baseline HIV RNA level equal or greater than 500 copies/mL had a higher risk of heart failure (adjusted HR 2.28; 95 percent confidence interval 1.57-3.32), while those with baseline as well as recent RNA level less than 500 did not (adjusted HR 1.10; 95 percent CI 0.64-1.89; P<.001 for comparison between high and low HIV RNA groups).
"The surprising finding from our study was the association of HIV with heart failure in the absence of prior coronary heart disease," said lead author Adeel Butt, MD, of the University of Pittsburgh School of Medicine. "On the other hand, if HIV replication is well-controlled, then the risk of heart failure is closer to that seen among HIV-uninfected persons," said Butt.
"Our results suggest that HIV itself is playing an important and independent role," Butt and colleagues wrote.
"Be on the lookout for early signs of heart failure in HIV-infected persons, even if there is no history of preceding coronary heart disease," Butts said. "Controlling HIV may well reduce the risk of heart failure."
The study, "Risk of Heart Failure with Human Immunodeficiency Virus in the Absence of Prior Diagnosis of Coronary Heart Disease," was published in Archives of Internal Medicine (2011;171(8):737-743).
04.25.2011; Megan Brooks
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