HIV may increase heart attack risk by 50 per cent

Infection with the human immunodeficiency virus (HIV) may increase the risk of heart attacks by 50 per cent, a new study has claimed.
Researchers, who analysed data from more than 82,000 veterans suggest that infection with HIV was associated with an increased risk of acute myocardial infarction (AMI, heart attack) beyond what is explained by recognised risk factors.
Due to the successful antiretroviral therapy (ART), people infected with HIV are living longer and are at risk for heart disease, authors wrote in the study published by JAMA Internal Medicine journal.
Matthew S Freiberg, of the University of Pittsburgh School of Medicine, and colleagues examined whether HIV infection was associated with an increased risk of AMI after adjusting for standard Framingham risk factors in a large group of HIV-positive veterans and a similar group of uninfected veterans.

Researchers found that during a median follow-up of 5.9 years there were 871 AMI events.
"Across three decades of age, the mean AMI events per 1,000 person-years was consistently and significantly higher for HIV-positive compared with uninfected veterans," researchers said.

The results indicate that for veterans aged 40 to 49 years, the events per 1,000 person-years were 2.0 for HIV-positive veterans vs 1.5 for uninfected veterans; for those aged 50 to 59 years, 3.9 vs 2.2 and for those aged 60 to 69 years, 5.0 vs 3.3.
After adjusting for Framingham risk factors, co-existing illnesses and substance use, HIV-positive veterans had an increased risk of incident AMI compared with uninfected veterans (hazard ratio, 1.48), according to the results.

The study also noted that an "excess risk" remained among those achieving an HIV-1 RNA level less than 500 copies/mL compared with uninfected veterans (hazard ratio, 1.39).
Researchers comment that the study's findings may not be generalisable to women because the group of patients studied was overwhelmingly male.
"That the HIV-positive cohort in the study by Freiberg et al experienced a 50 per cent increased risk of MI highlights the need for further research in women, research into the underlying mechanisms of the increased risk, and the development of specific interventions to reduce the risk of MI in HIV-positive populations," Patrick WG Mallon of the University College Dublin, Ireland, said in the journal.