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HIV may elevate risk for heart failure
Butt AA. Arch Intern Med. 2011;171(8):737-743.
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HIV infection proved to be an important risk factor for heart failure even after adjusting for traditional risk factors among more than 8,000 male veterans, according to a study appearing in the Archives of Internal Medicine.
Researchers examined 8,486 individuals (28.2% HIV-infected; median age, 48 years) who were enrolled in the Veterans Aging Cohort Study Virtual Cohort and the 1999 Large Health Study of Veteran Enrollees from January 2000 through the end of July 2007. Participants were excluded if they were diagnosed with cancer, with the exception of nonmelanoma skin cancer, or if they were female, due to the small number of women enrolled (n=276).
Over the study’s median follow-up of 7.3 years, 286 incident heart failure (HF) events were reported. After adjusting for age, race and ethnicity, the incidence of HF was 7.12 per 1,000 person years among those infected with HIV and 4.82 per 1,000 person years among those not infected. This led to a notably higher risk of HF among those with HIV-infection (HR=1.81; 95% CI, 1.39-2.36), which remained similar even among veterans who did not have a coronary heart disease event or alcohol dependency before the incident HF event.
Additionally, compared with HIV-uninfected participants, ongoing viral replication (HIV-1 RNA level >500 copies/mL) among those with HIV-infection was linked with a higher risk of developing HF (HR=2.28; 95% CI, 1.57-3.32), whereas infected veterans with baseline and recent HIV-1 RNA level less than 500 copies/mL did not have an increased risk of HF.
As areas for future research, the study authors suggested additional work be done to fully characterize the association between HIV infection and HF, and to understand the underlying mechanisms.
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