Studies Link Antiretrovirals With Cardiac Risks

Antiretroviral drugs boost cardiovascular risks by 26% per year of use for the first four to six years of their use, according to a study in the November 19 edition of The New England Journal of Medicine. The study of more than 23,000 HIV-positive patients is one of the first research projects to directly link heart attack risk with antiretroviral therapy. People taking anti-HIV drugs were shown to have about double the risk of a heart attack after four years of treatment than those just beginning drug therapy. Study subjects taking anti-HIV drugs the longest had the highest incidence of heart attacks. The researchers say the increased risk of heart attack was likely caused by elevated cholesterol and triglyceride levels in the blood of patients on highly active antiretroviral therapy. A French study in the November 21 edition of the journal AIDS showed that protease inhibitors may boost the risk of heart attacks, with HIV-positive men who have taken protease drugs for 18 months or longer having a higher heart attack rate than those not taking the medications. Other anti-HIV drug classes were not connected with increased cardiac risks, according to the study. The researchers linked the higher heart attack risk to insulin resistance, elevated blood lipid levels, and lipodystrophy, all of which have been associated with protease inhibitor use.