HIV Drugs May Raise Heart Attack Risk

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Writing in an accompanying editorial in the journal, Dr. James Stein, of the University of Wisconsin School of Medicine and Public Health, said the actual increase of risk for heart attack from protease inhibitors "is not high." In fact, it remains much smaller than the danger posed by more typical risk factors such as aging, smoking and diabetes.

"There does not appear to be an epidemic (of heart attacks) on the horizon -- simply a risk that needs to be managed," Stein wrote. So, instead of focusing on the relatively minor threat from HAART, "perhaps more effort should be spent assisting our (HIV-infected) patients with smoking cessation and the prevention of diabetes," he concluded.

Lundgren agreed with that assessment. "It is extremely important that patients infected with HIV are assessed for their overall absolute risk of cardiovascular disease; a risk that is derived from age, gender, a history of hypertension, diabetes and cardiovascular disease in the person her/himself, as well as a family history," he said.

As for the use of protease inhibitors, Lundgren said experts in the United States and Europe are currently drafting new guidelines to help doctors better manage drug-linked heart risks.

The new findings could also spur the development of even safer anti-HIV drugs, Johnston added.

"People are looking at individual protease inhibitors and asking, 'Are any of these drugs more or less likely to increase cholesterol, increase LDL ('bad' cholesterol), to lead to a loss of bone density?'" she said. "All of these side effects that have been associated with antiretroviral therapy in general."

More information

Find out more about HIV/AIDS at the U.S. National Institute of Allergy and Infectious Diseases.