Heart attack risk in HIV drug: study

People living with HIV may need to be more proactive about their heart health after clinical researchers in Sydney have proved a commonly used HIV drug type can increase the risk of heart attacks.

The study, conducted by the Garvan Institute of Medical Research’s Associate Professor Katherine Samaras and Professor Andrew Carr, has shown for the first time that commonly used protease inhibitor drugs can increase the risk of heart attack.

Samaras told Southern Star the study, which involved 20 participants, showed that certain drug types rather than the virus itself could be blamed for an increased risk of heart attacks.

“One of the criticisms that is often levelled by people or bodies, we might call non-believers, has been that it’s the virus that is doing it,” she said.

“What we were able to do was take out the effect of the virus, take out the effect of multiple drug [therapies]… take out all these potential confounders that are in a lot of the other studies.

“We were able to show, no, it’s not the virus it’s likely to be the drugs.”

The study looked at two drugs. Ritonavir, described as the backbone of HIV treatment, was found to increase cholesterol levels. Newer drug Raltegravir showed to have less metabolic impact on cholesterol levels.

Samaras said people on HIV drug treatments should not take the results to mean they should switch drugs.

“We need to think about not just our counts and viral loads today, six months and in two years, but we need to think about our health in the next 20 to 30 years and how to avoid the diseases of normal ageing that occur at a more accelerated rate in people with treated HIV.

“We need to consider everything — whether we smoke or not, do we know our cholesterol and is it good, we need to consider our weight or waistline and work on abdominal obesity, and we need to exercise on a regular basis.”

Samaras said while the study doesn’t identify the pharmaceutical parts of drugs that cause the increase in heart attacks, it highlights the need for more research and a more holistic approach to HIV health management.

“If people have multiple heart risk factors that are very strong, then I think our study highlights that maybe we should also be looking at these drugs under the microscope to make sure we’re managing their global risk factors,” she said.

“We need to be looking at the whole picture. We need to be thinking about the drugs but as part of an entire picture of heart health.”