"The fact that the vast majority of cardiac deaths were sudden is surprising and implies that we as clinicians need to be aware of this potential health issue among patients with HIV," Hsue added. "Our findings also highlight many things that we still don't know about HIV and sudden death. Did these individuals die of unrecognized coronary artery disease? What can we be doing as clinicians to identify patients at risk and to intervene beforehand?"
Categorizing Sudden Cardiac Death
By 2003, sudden cardiac death made up the largest number of non-AIDS deaths among HIV-positive patients in San Francisco. These deaths were largely among individuals with evidence of well-controlled HIV disease.
Researchers used well-published criteria for retrospectively identifying death as either HIV-related or sudden death-related. If there was any doubt, they classified sudden death as an HIV death.
"In other words, for someone with a CD4 (T-cell) count less than 50 who died suddenly, we classified that as an HIV death, rather than a sudden death because of the profound immunodeficiency," Tseng said.
More than 17,000 people with AIDS died in 2009 worldwide, and more than 619,000 people have died since the epidemic began. Still, the number of people living with HIV continues to rise. More than 1.2 million people in the United States are HIV-positive, according to the U.S. Department of Health & Human Services.
"Now that HIV-infected individuals are living longer with the benefit of antiretroviral therapy, non-AIDS conditions are becoming increasingly important and at the top of this list is cardiovascular disease," Hsue said.
Researchers believe HIV changes the electrophysiology of the heart in a
|Contact: Leland Kim|
University of California - San Francisco