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Heart Risks Emerging in People With HIV
Date:6/19/2008

The virus, medications, or both might be the culprit, experts say

THURSDAY, June 19 (HealthDay News) -- Drugs that suppress HIV are keeping infected individuals alive and relatively healthy for years, even decades. But studies suggest that a new health risk is emerging for these long-term survivors: increased odds for heart attack and stroke.

It's not clear whether the cause is the virus itself or the drugs used to treat it, said Dr. Steven Grinspoon, professor of medicine at Harvard University.

The exact cause of heightened heart risk among HIV patients "may not be just one or the other," he said. "Both may act, in different ways. The drugs may be causing metabolic problems such as dyslipidemia in the traditional way, while the virus can cause inflammation, which is a known factor in atherosclerosis."

Dyslipidemia is an abnormal increase in levels of blood fats such as cholesterol. Having HIV is associated with low levels of "good" HDL cholesterol and high levels of the blood fats called triglycerides, experts have noted.

And studies have shown that HIV drug therapy can cause abnormal accumulations of fat around the organs deep in the abdomen. The U.S. Food and Drug Administration said in March that it was studying the possibility of label changes for two HIV drugs, Ziagen and Videx, because studies showed a higher rate of heart attacks among people taking them.

Whatever the cause, studies, including one led by Grinspoon, show that living with HIV increases the risk of cardiovascular disease by about 70 percent, he said.

"The relative risk is higher for women than for men," Grinspoon said. "It also increases with increasing age. A lot of HIV people are young, so the absolute rates are low, because they are young."

Grinspoon is co-chair of a meeting on HIV and cardiovascular risk, the conclusions of which are reported in both Circulation and the Journal of Acquire
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