HIV patients may be at higher risk for heart attack

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Men with HIV may be at an increased risk of having a heart attack, according to a new study.

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Human immunodeficiency virus (HIV) is a virus that destroys the immune system and can lead to AIDS. The Centers For Disease Control and Prevention estimates that 1,148,200 people 13 and older have been infected with HIV, and 18.1 percent of them are unaware they have the virus. About 50,000 people are infected with HIV each year.

HIV is spread through sexual contact, blood and from mother to child. Symptoms of HIV infection include diarrhea, fatigue, fever, frequent vaginal yeast infections, headache, mouth sores, muscle stiffness or aching, rashes of different types, sore throat and swollen lymph glands. However, many people may not have any symptoms when they are diagnosed with HIV.

Researchers looked at 82,459 subjects, 27,350 of which were HIV-positive veterans and the rest uninfected veterans. They were followed for a median of 5.9 years.

During this time frame there were 871 acute myocardial infarctions (AMI), otherwise known as heart-attacks. One hundred seventy-six incidents were fatal. About 42 percent of all the cardiac events happened to people with HIV.

For veterans between the ages of 40 and 49, there were 2.0 AMIs per 1,000 person-years for HIV-positive subjects, compared to 1.5 AMIs for non-infected. The numbers increased to 3.9 AMIs versus 2.2 AMIs for infected veterans 50- to 59-years old and non infected veterans in that age group respectively. Those who were ages 60 to 69 had 5.0 AMIs per 1,000 person-years compared to just 3.3 for the group who did not have the virus.

When other risks such as high blood pressure, diabetes and drug and alcohol use were factored in, HIV-infected subjects were still 48 percent more likely to have a heart attack.

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Because most of the subjects were male, they could not generalize the results for women as well. However, Patrick W.G. Mallon, who is with the University College Dublin in Ireland, said in a related commentary that it did show some warning for the general HIV-infected population. He believed more studies should be done.

"Although the cohort studied was almost exclusively male (>97 percent), the results demonstrate a clear and consistent excess risk of MI [myocardial infarction] (approximately 50 percent increase) in HIV-positive people across a range of age groups, with the association between HIV status and MI remaining significant when controlled for a number of covariates including traditional cardiovascular risk factors, such as lipids, blood pressure, and smoking status," he wrote.

Study author Dr. Matthew Freiberg, an associate professor of medicine and epidemiology at the University of Pittsburgh School of Medicine in Pennsylvania, said the researchers did not know why patients with HIV were more likely to have cardiac events but speculated that the HIV and the medication used to treat it -- called antiretroviral therapy (ART) -- may play a role.

"It may be that HIV as it's in your body, like other infections, may be promoting an inflammatory response that is leading to these increased risks of heart attack," he told Reuters.

The study was published online on Mar. 4 in JAMA Internal Medicine.