Small increase in risk of MI for those treated with antiretrovirals
Combination antiretroviral therapy is independently associated with an increase in risk of myocardial infarction (MI), according to the authors of a new study.
European, American and Australian researchers collected data for over
23,000 HIV-infected patients between 1999 and 2002. Over an average of
1.6 years, 126 patients had an MI. “Although the absolute event
rate was low, combination antiretroviral therapy was associated with
a 26 per cent relative increase in the rate of MI per year of exposure
during the first four to six years of use,” the researchers estimate.
The researchers point out that the benefits of combination antiretroviral
therapy, defined as any regimen that included a protease inhibitor or
a non-nucleoside reverse transcriptase inhibitor, continue to outweigh
the increased risk of myocardial infarction. The absolute rate for myocardial
infarction for these patients was less than 0.6 per cent (New England Journal of Medicine 2003;349:1993).
The authors of an accompanying editorial (ibid, p2065) suggest that patients
taking combination antiretroviral therapy should be advised to make lifestyle
changes, such as stopping smoking. They also suggest that patients with
unfavourable lipid profiles should be managed with lipid-lowering drugs
and changes to their diet. |
