Heart attack risk higher amongst people living with HIV

Data presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2022) in the United States shows that the risk of a myocardial infarction (heart attack) is significantly higher for people living with HIV than those without.

Speaking at the conference, Michael Silverberg PhD MPH, of Kaiser Permanente said “Cardiovascular disease remains the leading cause of morbidity and mortality in the US, and the risk is much higher in HIV patients, 40% to 80% higher, and that's likely due to several factors”

In a study, led by Silverberg, data was analysed for heart attack risk during two window periods 2005-9 and 2010-17. Data from 33,330 people across two health care systems was used.

Participant make up:

• 10,312 living with HIV
• 23,018 without HIV
• 87% were male
• Median age: 43
• Mean cholesterolL 180mg/dL
• Mean systolic blood pressure: 123mmHg
• Mean HDL: 44 mg/dL
• 26% were smokers
• 25% were receiving treatment for hypertension
• 6% had diabetes
• 238 participants experienced a heart attack.

The data showed that for the period 2005-9 the adjusted risk for a heart attack amongst people living with HIV was 0.99 (95% CI, 0.67-1.45), however this increased to 1.85 (95% CI, 1.26-2.72) for the period 2010-17.

“The results appear to be driven by a decrease in the MI risk over time for people without HIV, that was not seen for their counterparts”

“HIV-specific factors such as longer duration of HIV and use of new ART may have prevented people with HIV from realising the same improvements in MI risk as people without HIV”

“With an aging cohort of people with HIV and potential adverse effects of newer ART, such as integrase inhibitors and the potential related weight gain, it is critical to continue modern monitoring trends and MI rates by HIV status,” said Silverberg.