Is HAART hard on the heart?

From Seattle, at the 9th Annual Conference on Retroviruses and Opportunistic Infections

Multiple-drug regimens known as highly active antiretroviral therapy, or HAART, have been literally a lifesaver for people with AIDS. But several commonly used antiretroviral drugs, especially those called protease inhibitors, boost fatty acid and cholesterol concentrations in patients’ blood.

These are known risk factors for heart disease in healthy people. That’s led many physicians to suspect that heart trouble may lurk on the horizon for people taking drugs to control their HIV infection. Two large studies presented at the conference come to opposite conclusions about that risk.

A study sponsored by the Centers for Disease Control and Prevention (CDC) in Atlanta followed 5,676 HIV-infected people from 1993 to 2001. Half took protease inhibitors. Only 15 suffered heart attacks, but 13 of those were getting the drugs.

Another study looked at 36,766 veterans being treated for HIV across the country. Between 1993 and 2001, overall mortality declined sharply–reflecting the benefits of HAART in fighting off AIDS-related deaths. Hospital admissions and deaths related to cardiovascular disease also declined. The study was conducted by the Veteran’s Administration.

“It’s not possible to say which [study] is right, but it is a critical topic in the years to come,” says the CDC’s Harold Jaffe. Known benefits of protease inhibitors, he says, continue to outweigh their risks.

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