The review of 45 studies by researchers from The School of Cardiovascular and Metabolic Medicine & Sciences and the London School of Hygiene and Tropical Medicine is published today in JAMA. People with HIV are much more likely to die of other causes besides AIDS and the leading cause of death is due to heart disease. However, it is not well understood why people with HIV are at greater risk of heart disease and whether HIV directly affects the heart muscle or the arteries that supply that muscle.
Researchers collected all the studies that used advanced imaging techniques to better understand the potential ways on how HIV infection affects the heart. Many of these studies originated from developed countries, despite the global burden of HIV mainly prevalent in sub-Saharan Africa. Additionally, most the individuals studied were older men, even though much of the global HIV population is younger women.
The analysis found just over a third of the studies showed a relationship between having HIV infection and disease in the heart arteries. However, these studies showed a lot of variation in the strength of the relationship. Nearly half of the studies showed a relationship between having HIV infection and disease in the muscle of the heart, but there was also a variation in the strength of this relationship.
As HIV becomes a chronic disease and individuals live longer, they are at greater risk of developing heart disease. It is vital we try and understand how HIV and AIDS causes heart disease, a problem which our study indicates remains unanswered. In addition our research points to an urgent need for studies to be conducted in low income countries, and in particular in sub Saharan Africa where the burden of HIV is greatest.– First author Jonathan Hudson, from The School of Cardiovascular and Metabolic Medicine & Sciences