A new study published this week in health journal The Lancet HIV revealed that common co-existing factors such as smoking, high cholesterol levels, and high blood pressure are serious issues for those living with HIV. Addressing and combating these issues would greatly reduce HIV-positive people’s rates of heart attacks, non-AIDS-related cancers, and end-stage liver disease and kidney disease—conditions that combined kill more poz folks than HIV-related illnesses.
According to NAM’s AIDSmap, this analysis by NA-ACCORD brought together clinical cohorts at more than 200 sites in North America, following over 180,000 people living with HIV. Researchers found that tackling traditional risk factors for these conditions would have a far greater impact on health and longevity than focusing simply on HIV treatment alone.
The researchers emphasized the importance of screening and management of these conditions in the lifelong care of people living with HIV. The virus is known to increase the risk of cardiovascular disease and some cancers, but whether HIV-associated risk factors are greater than more general risk factors to the development of these conditions in poz folks has not be studied in depth. That has led to a lack of prioritization of screening for risk factors among those living with HIV, but the scientists say, this is a mistake.
Preventing (or quitting) smoking, lowering cholesterol, controlling blood pressure, and curing hepatitis C would could all dramatically alter—and save—the lives of many poz people, the study found.
Controlling blood pressure could prevent 39 percent of cases of end-stage kidney disease in those with HIV, and controlling cholesterol could prevent 22 percent of cases. Maintaining a viral load below 400 copies/ml could prevent another 19 percent of cases. (Uncontrolled viral load can lead to HIV-associated kidney damage, especially in African Americans.) Preventing diabetes, a common cause of kidney disease in the general population, could prevent 6 percent of cases.
When it comes to heart attacks, the study found that among people living with HIV smokers were 82 percent more likely to suffer a heart attack, people with high cholesterol were nearly three times more likely to suffer a heart attack and those with high blood pressure were almost three-and-a-half times more likely to have a heart attack. Lowering these risk factors would go a long way in preventing heart disease.
“The evidence from our study is clear,” the investigators conclude. “To avoid sizeable proportions of non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease, the continued focus on maintaining HIV viral load suppression after ART [antiretroviral therapy] initiation must be balanced with screening for traditional risk factors, effective interventions to reduce the burden of traditional risk factors, and a sustainable model of care with the capacity to provide traditional risk factor interventions over the decades of life with HIV.”
AIDS-related illnesses aren’t (and haven’t been for some time) the biggest threat to the lives of HIV-positive people. Now there are more reasons than ever to tackle these other health risks that are killing those living with HIV.