Long-Term Protease Inhibitor Treatment Increases Men’s Risk for Heart Attack, Study Says
Long-term antiretroviral drug treatment including protease inhibitors increases HIV-positive men's risk for heart attack, according to a study published in the Nov. 21 issue of the journal AIDS, Reuters Health reports. Dr. Murielle Mary-Krause and colleagues in Paris examined the records of almost 35,000 HIV-positive men contained in a French hospital database. The researchers discovered that 60 of the men had a heart attack between 1996 and 1999, including 49 men whose antiretroviral regimen included protease inhibitors. The estimated rate of heart attack among the HIV-positive men was 8.2 per 10,000 annually for men treated with a protease inhibitor for less than 18 months, according to Reuters Health. The heart attack rate nearly doubled to 15.9 for men treated with a protease inhibitor for 18 to 29 months and doubled again to 33.8 for those treated with a protease inhibitor for 30 months or longer. The heart attack rate in the general male population is 10.8 per 10,000. Although the life expectancy gained by taking antiretroviral treatments that include protease inhibitors "far outweighs" the increased heart attack risk, physicians should consider patients' cardiovascular disease risk factors when deciding whether to prescribe protease inhibitors, the researchers concluded. In an accompanying editorial, Dr. Peter Reiss of the University of Amsterdam, writes, "It seems prudent to at least consider individually managing patients with respect to their risk of developing coronary artery disease," adding that doctors should encourage HIV-positive patients to stop smoking and appropriately modify diet and exercise (Reuters Health, 12/17).This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.