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HIV replication linked to higher chance of heart failure

Kathleen Blanchard's picture
HIV and heart failure

In an analysis, published in the Archives of Internal Medicine, researchers used a population-based, retrospective cohort study of veterans, finding an 80 percent higher chance of heart failure among individuals with active HIV infection.

Active HIV ups heart failure risk 80 percent

Data was taken from the Veterans Aging Cohort Study Virtual Cohort and the 1999 Large Health Study of Veteran Enrollees that included 8,486 patients Twenty three percent had HIV. The studies took place from January 1, 2000, to July 31, 2007.

Adeel Butt, MD, of the University of Pittsburgh School of Medicine, and colleagues found heart failure risk was highest in patients with active HIV infection whose RNA levels were 500 or more copies per milliliter (mL).

After adjusting for age, race and ethnicity, the investigators looked at individual risk factors responsible for that included smoking, increased body mass index, diabetes and alcohol use that they also eliminated. Excluded were individuals with a history of coronary artery disease.

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After adjusting for the usual and known heart failure risks, the strongest association was from viral replication - 7.12 per 1,000 person-years among those with HIV and 4.82 per 1,000 person-years in the rest of the cohort.

Patients whose viral load was less than 400 copies per milliliter were not found to be at higher risk for the disease.

Women were excluded from the study and the results relied on ICD 9 codes rather than clinical outcomes, potentially limiting the accuracy of the findings. The analysis suggests HIV infection with ongoing viral replication is an independent risk factor for heart failure, concluded by the study authors.

Arch Intern Med. 2011;171(8):737-743. doi:10.1001/archinternmed.2011.151
"Risk of heart failure with human immunodeficiency virus in the absence of prior diagnosis of coronary heart disease"
Adeel A. Butt, MD, MS et al

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