Individuals with the human immunodeficiency virus (HIV) are twice as likely to develop cardiovascular disease (CVD), according to a global analysis published on July 18 in the American Heart Association’s journal Circulation.
Researchers, led by Anoop Shah, MD, MPH, of the University of Edinburgh in the Scotland, conducted a review of studies from 153 countries to determine the rate and risk of CVD in HIV-infected individuals.
They also sought to determine the national, regional and global estimates of disability-adjusted life years (DALY)—healthy years lost due to illness, disability or death—from HIV-associated CVD over a 15-year period at a regional and global level.
"This study has important implications when planning cardiovascular preventative policies in low resource countries where the burden of HIV remains high and that of cardiovascular disease is growing," Shah said in a prepared statement.
Shah and colleagues studied more than 793,000 HIV-infected individuals with a total follow-up of 3.5 million person-years. In their analysis, the researchers found:
- The rate of CVD was 61.8 per every 10,000 person-years—which is comparable to other high-risk cardiovascular groups including diabetes.
- Compared to individuals not infected with HIV, the risk ratio for HIV-infected individuals who developed CVD was 2.16—or double the risk of CVD development.
- Over the last 26 years, people who developed CVD due to HIV infection increased from 0.36 percent to 0.92 percent.
- The DALYs increased from 0.74 in 1990 to 2.57 million in 2015—globally, the healthy years lost tripled as more people infected with HIV are living longer.
- Two-thirds of the burden was found in sub-Saharan Africa and in the Asia Pacific region. Swaziland, Botswana and Lesotho were impacted the most.
The researchers noted the mechanisms behind the link between HIV and CVD are still unknown. However, they said possible mechanisms include inflammation of blood vessels.
"We now have clear evidence that your risk of heart and circulatory disease is doubled if you have HIV,” said Jeremy Pearson, PhD, Associate Medical Director at the British Heart Foundation, that funded the study. “This news will have major public health implications globally, but particularly in developing countries in Africa where the burden of HIV is higher. The effects of one disease on another are often poorly understood. But, with an ageing population, the number of people living with more than one disease will continue to rise. It's essential we build our understanding of the interplay between conditions so we can give patients the best treatments and advice."
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.