A new study shows that the risk of heart attack increases the longer someone has been living with HIV. This is an ‘extra’ effect, on top of what can be expected as people get older and in addition to the impact that some anti-HIV drugs may have on the risk of heart attack. This is likely to be because the presence of HIV in the body causes inflammation; that is, the active response of the immune system against the infection. This happens even when HIV is well controlled with treatment. Inflammatory chemicals seem to contribute to the process of atherosclerosis – the hardening and narrowing of arteries – that leads up to a heart attack. After making statistical adjustments for people’s age and for the anti-HIV drugs they were taking, the researchers found that the risk of heart attack increased with the number of years that a person had been living with HIV:
– during the first five years of having HIV, four people in every 10,000 had a heart attack each year
– among those who’ve had HIV for five to ten years, eight people in every 10,000 had a heart attack each year.
– and in people who’ve had HIV for more than fifteen years, this rose to 26 people in every 10,000 having a heart attack.
Surprisingly, having a high or an undetectable viral load did not make any difference to the risk of heart attack. But having a low CD4 count (below 100) did substantially raise the risk.
We know from the general population that the risk of a heart attack increases as people get older. But this study showed that each ten years of HIV infection had a similar impact to ten years of ageing on the risk. In other words, a person living with HIV aged 40, infected with HIV for ten years, might have a similar risk of heart attack as a person without HIV aged 50. Although there is an increased risk for a person living with HIV, the size of the increased risk is small compared to other risk factors such as smoking.
This underlines the importance of people with HIV improving their diet, getting more exercise and giving up smoking to reduce their risk. This is especially the case for people who have had HIV for a long time.
The full article can be read here.