HIV doubles heart disease

HIV-associated cardiovascular disease has more than tripled in the past 20 years, with Swaziland, Botswana and Lesotho particularly affected.

This is according to a research by the University of Edinburgh. An international team of experts, led by staff at the university, reviewed studies from 153 countries to determine the rate of heart disease in people living with HIV.

Using a sample group of almost 800 000, researchers found the risk of cardiovascular disease among people living with HIV was double that among uninfected people.

The link between HIV and heart disease is poorly understood. Scientists think the virus may cause inflammation of blood vessels, putting pressure on the cardiovascular system.

The virus is also thought to raise fat levels in the blood and affect the body’s ability to regulate sugar levels, which may also contribute to heart disease.

More than two-thirds of the burden of HIV-associated heart disease was found in sub-Saharan Africa and AsiaPacific regions.

Over the last 26 years, the global population-attributable fraction from cardiovascular disease due to HIV increased from 0.36% to 0.92% and disability-adjusted life years increased from 0.74 million to 2.57 million.

There are more than 35 million people infected with HIV worldwide, a figure that is steadily increasing.

Those infected are now more likely to die from chronic diseases such as cancer or cardiovascular disease because life-saving medications can keep the virus in check.

National estimates of prevalence and cardiovascular burden were available for 154 countries. The highest population-attributable fraction was observed in countries within sub-Saharan Africa, with HIV accounting for more than 15% of the cardiovascular burden in Swaziland, Botswana, Lesotho and South Africa

“Whether patients living with HIV should be considered high-risk and implemented on appropriate primary prevention pharmacotherapy such as statin therapy remains unclear,” the researchers said.

University of Edinburgh cardiology clinical lecturer Dr Anoop Shah said this study has important implications when planning cardiovascular preventative policies in low-resource countries where the burden of HIV remains high and that of cardiovascular disease is growing.

British Heart Foundation associate medical director Professor Jeremy Pearson said: “We now have clear evidence that your risk of heart and circulatory disease is doubled if you have HIV.”

“The effects of one disease on another are often poorly understood,” he added. “But, with an ageing population, the number of people living with more than one disease will continue to rise.

“It’s essential we build our understanding of the interplay between conditions so we can give patients the best treatments and advice,” he added.

Antiretroviral efficacy means deaths from other ailments now more likely