French HIV-positive patients have increased risk of heart attack

HIV-positive people in France have an increased risk of heart attack, according to research published in the online edition of AIDS. Compared to the general, age-matched French population, the risk of heart attack was increased by 50% for HIV-positive men and by 170% for women with HIV.

A number of studies have shown that patients with HIV have an increased risk of heart attack. France has a lower incidence of heart attack than many English-speaking and northern European countries.

Therefore, investigators gathered information on the incidence of heart attack amongst HIV-positive patients in France between 2000 and 2006. This was compared to the heart attack incidence amongst men and women in the general population aged between 35 and 64 in three French regions. The researchers then calculated if HIV-positive men and women had an increased risk of heart attack.

A total of 74,958 HIV-positive individuals whose details were recorded in the French Hospital Database on HIV were included in the study. These patients contributed a total of 298,000 person-years of follow-up.

There were a total of 360 heart attacks, providing an overall incidence of 1.24 per 1000 person years.

When the investigators restricted their analysis to HIV-positive individuals aged between 35 and 64, the incidence of heart attack increased to 1.42 per 1000 person-years.

Heart attack incidence for HIV-positive men aged between 50 and 54 was 3.4 per 1000 person years compared to an incidence of 1.9 per 1000 person years in the general French male population. Incidence of heart attack was much higher for HIV-positive women in their early 40s than HIV-negative women of the same age (1.6 per 1000 person-years vs. 0.1 per 1000 person-years).

Compared to the general French population aged between 35 and 64, individuals with HIV between these ages were 50% more likely to experience a heart attack. However, the risk varied according to sex and was higher for HIV-positive women (standardised morbidity ratio [SMR] = 2.7; 95% CI, 1.8 to 3.9) than HIV-positive men (SMR = 1.4; 95% CI, 1.3-1.6).

“The higher relative risk of myocardial infarction [heart attack] found in younger men and women in our study raises the possibility of a premature aging effect of HIV on the cardiovascular system,” comment the investigators.

They conclude, “in France, a country with a low incidence of myocardial infarction in the general population, the risk of myocardial infarction is increased in HIV-infected patients, and this increase is unlikely to be explained only by classical cardiovascular risk factors.”