Risk of cardiovascular disease in patients with HIV infection undergoing antiretroviral therapy

Abstract

HistoryThe increased survival of patients with HIV infection thanks to antiretroviral therapy (ART) is accompanied by a higher rate of cardiovascular disease (CVD). We analysed the prevalence of the cardiovascular risk factors (CRFs) and estimated the risk of CVD in a cohort of patients with HIV in Spain. MethodsWe conducted a cross-sectional, observational study of CRFs in the Spanish VACH cohort of patients with HIV who undergo ART. ResultsThe study assessed 15,559 patients with HIV (76 % men; mean age, 46 years). Some 3.7 % had experienced at least 1 CVD event. The prevalence of CRFs was high (hyperlipidaemia, 64 %; tobacco use, 47 %; arterial hypertension, 22 %; and diabetes, 16 %). According to the Framingham scale, 10.9 % of the patients presented a high CVD risk, and 28.8 % presented a moderate risk. Of the patients with a high CVD risk, 49 % took protease inhibitors and 43 % took abacavir. Fifty-three percent of the patients diagnosed with arterial hypertension took antihypertensive drugs, and 2.6 % of the patients with diabetes took antidiabetic agents. ConclusionsClassical CRFs are common in patients with HIV undergoing ART in Spain, and a large proportion of them have a moderate-high risk of CVD. Therefore, controlling the modifiable CRFs in patients with HIV should be improved, and the use of drugs with a better cardiovascular risk profile should be assessed.