Patients infected with HIV have a sharply higher risk of clogged arteries, and the disease appears to progress especially quickly, researchers reported on Monday. They said infection with the virus should be considered a risk factor for heart disease, especially atherosclerosis--clogging and hardening of the arteries. "Our finding suggests that it would be reasonable to consider HIV infection a cardiac risk factor," Priscilla Hsue, assistant professor of medicine at the University of California, San Francisco, said in a statement. "Other risk factors, such as high cholesterol and high blood pressure, need to be aggressively treated in HIV patients--even if it means changes in their HIV medications to control cholesterol levels."
Writing in the American Heart Association journal Circulation, Hsue and colleagues said they studied 148 HIV-infected patients. The patients on average were 45 years old, infected for 11 years, and treated with antiretroviral cocktails including protease inhibitors for an average of 3.3 years. They were compared with 63 uninfected adults matched for age and gender. The researchers used ultrasound to measure the thickness of the carotid arteries, which are found in the neck and supply blood to the brain. Thickness of this artery is an indication of atherosclerosis. The average carotid artery was significantly thicker in the HIV patients than the normal healthy "controls," and buildup of fatty plaque was found in 45% of the HIV patients, compared with 24% of controls. A year later the arteries had grown thicker in some of the HIV patients, and the rate of thickening was faster than in noninfected patients.
"In the HIV patients, the extent of atherosclerosis was associated with classic cardiac risk factors such as age, cholesterol levels, cigarette smoking, and high blood pressure," Hsue said. HIV itself could be a cause, she said, because those patients with the most damaged immune systems had the worst atherosclerosis.