Men with HIV have a greater risk and extent of coronary artery disease
Men with HIV have a greater risk for coronary artery disease (CAD) and have more severe disease than uninfected men.
Annals of Internal Medicine
Patients with HIV are living longer and, as such, are experiencing more chronic noninfectious age-related diseases such as CAD. Data has suggested a connection between HIV infection or its treatment and CAD, but the data are inconsistent.
Researchers used cardiac computed tomography (CT) to measure coronary artery calcium and coronary CT angiography to assess plaque extent and characteristics in HIV-infected men and a control group. The control group consisted of uninfected men with similar demographics (age and race), CAD risk factors, and lifestyle (men who have sex with men) to the study patients. Even after adjusting for demographic variables and known risk factors for CAD, the men with HIV had a greater prevalence and extent of noncalcified plaque, the kind that is more prone to rupture, potentially leading to heart attacks.
Men with more advance HIV infection and a greater number of years on antiretroviral therapy had a higher prevalence of clinically significant coronary stenosis greater than 50 percent.
The authors suggest an effort to address and reduce traditional cardiovascular risk factors to improve long-term outcomes for HIV-infected men.
W.S. Post, M. Budoff, L. Kingsley, F.J. Palella Jr., M.D. Witt, X. Li, R.T. George, T. Brown, L.P. Jacobson. Associations Between HIV Infection and Subclinical Coronary Atherosclerosis. Annals of Internal Medicine (2014). Volume 160, Issue 7, Page(s) 458-467, http://www.annals.org/article.aspx?doi=10.7326/M13-1754
J.S. Currier, J.H. Stein. HIV and Atherosclerosis: Moving From Associations to Mechanisms and Interventions. Annals of Internal Medicine (2014). Volume 160, Issue 7, Page(s) 509-510 http://www.annals.org/article.aspx?doi=10.7326/M14-0378
Annals of Internal Medicine – http://www.annals.org/article.aspx?doi=10.7326/M14-1754