HIV and your heart

There is a lot of debate about the causes of cardiovascular disease, but the most important seem to be the damage caused by untreated HIV infection, and traditional risk factors such as smoking. But several studies have shown that treatment with some anti-HIV drugs increases the risk of heart disease.

In recent research, US doctors looked at rates of cardiovascular disease in over 10,000 HIV-positive people between 1997 and 2007.

They found that people who took abacavir were about 50% more likely to have a heart attack or other serious cardiovascular event than people taking tenofovir or other drugs. Abacavir was also associated with an increased risk of stroke.

But they also found that people who took tenofovir, especially if they had poor kidney function, had an increased risk of heart failure (a gradual weakening of the heart).

The results of all studies looking at the risk of cardiovascular disease in people with HIV need to be seen in a wider context. Heart attacks are very rare in people without major risk factors like smoking, high cholesterol and a family history of heart disease.

A 50% increase in risk is a cause for concern in anyone already at high risk of heart attack. But in otherwise healthy people, a doubling of risk would still mean a heart attack was a very rare event.

The risk associated with any individual drug has consistently been shown to be less important than those associated with factors such as smoking and uncontrolled HIV.

Routine HIV care involves regular tests to monitor cardiovascular health, meaning that problems can be spotted early and action taken.

There’s also a lot you can do to look after your heart – for example not smoking, eating a healthy diet, and exercising regularly – help and advice about all these is available from your HIV clinic or GP.