HIV Infection Linked to 40% Increase in Veterans’ Risk of Developing Heart Failure

Risk Manifests Much Earlier in Those Patients

By Annette M. Boyle

WEST HAVEN, CT — Antiretroviral therapy has extended the lives of veterans with human immunodeficiency virus (HIV) by decades, but a new threat could cut back their longevity.

A study published recently in JAMA Cardiology found that veterans with HIV had a 40% increase in heart failure of all types. Those patients had a 61% elevated risk of heart failure with reduced ejection fraction and a 21% increase in heart failure with preserved ejection fraction compared to veterans without HIV infection.1

Veterans with HIV were also found to have a 21% higher risk of borderline heart failure with preserved ejection fraction than other veterans.

During the study, 2,636 heart failure events occurred over a median follow-up period of 7.1 years, with HIV-diagnosed veterans experiencing 941 of those events. Heart failure with reduced ejection fraction accounted for 40% of all events.

“Not only are we seeing a higher rate of heart failure among this group, we are seeing it present decades earlier than expected,” explained lead author Matthew Frieberg, MD, associate professor of Cardiovascular Medicine at Vanderbilt University in Nashville, TN.

The study is touted as the first to show an increased risk of heart failure associated with HIV in the recent antiretroviral therapy (ART) era of HIV. It challenges the assumption that heart failure with reduced ejection fraction had faded as a problem for people living with HIV in high-income countries where ART is available, according to an accompanying editorial.

Still, the authors said they were not surprised to find the increased risk. “Heart failure, like other organ system failures, is often the result of prolonged injury, such as occurs with chronic HIV infection,” pointed out co-author Amy Justice, MD, PhD, lead investigator of the Veterans Aging Cohort Study (VACS) and professor at the Yale School of Public Health in New Haven, CT.

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