New research suggests that HIV infection increases the risks of heart attack and stroke as much as traditionally recognized risk factors such as diabetes and smoking, according to the results of a study in the journal AIDS.

Although HIV infection and its treatment have been linked to increased cholesterol levels and diabetes, the new findings indicate that HIV infection itself is a risk factor for blood vessel disease in the heart and brain.

Dr. Carl Grunfeld and colleagues from the San Francisco VA Medical Center and the University of California used ultrasound to assess narrowing in the carotid arteries of 433 HIV-infected adults and 5749 similar adults without infection. The carotid arteries, located on each side of the neck, carry oxygenated blood to the brain.

Carotid narrowing was much more pronounced in the HIV-infected patients than in the uninfected subjects, the authors found. Further analysis confirmed that the difference was almost entirely related to HIV infection and not to other cardiovascular risk factors, such as High cholesterol levels.

The impact that HIV infection has on the risk of heart disease and stroke is similar to that seen with smoking and diabetes, Grunfeld told Reuters Health.

“Thus,” he added, “the doctor in the office looking at the usual numbers they use to assess cardiovascular risk (age, gender, blood pressure, smoking, cholesterol, diabetes) will underestimate the risk of heart attack and stroke in HIV-infected patients.” Such patients may require more aggressive treatments to lower cholesterol levels, he said.

By Megan Rauscher
SOURCE: AIDS 2009.