DENMARK: AIDS Drug Cocktails May Double Heart Risk

Wall Street Journal (02.24.05) - Thursday, February 24, 2005

Marilyn Chase AIDS drug cocktails may double the risk of heart attacks,
a risk comparable with smoking cigarettes, University of Copenhagen
researcher Dr. Jens Lundgren said at the 12th Conference on
Retroviruses and Opportunistic Infections in Boston. Lundgren's study
reported 277 heart attacks among 23,441 AIDS patients whose median age
was 39.
"You wouldn't expect myocardial infarcts [heart attacks] in that
young a population," Lundgren said at a news conference.
Lundgren emphasized that the risk of heart attack in AIDS patients
taking drug cocktails is greatly shadowed by the huge life-expectancy
gains that result from the drugs. In 1995, before the era of HAART, the
AIDS death rate was 23 percent a year; it is currently 1.5 percent to 2
percent a year among treated patients, he noted.
AIDS patients taking HAART should try to alter lifestyle risk factors
such as diet, said Lundgren. Cholesterol-lowering drugs and smoking
cessation should be considered. "If you smoke, you increase risk 1 to
twofold," Lundgren said. "If you quit, your heart forgives you."
Separately at the conference, Dr. Anthony Fauci, director of the
National Institutes of Health's National Institute of Allergy and
Infectious Diseases and the government's top AIDS research scientist,
warned that the days of double-digit funding increases for AIDS are
over for now, with health concerns like bioterrorism, SARS, and avian
influenza competing for dollars.
"We have to face the challenge of making the most of scientific
opportunities in drugs and vaccines" during times of fiscal restraint,
said Fauci, speaking at an afternoon preview of a policy speech to be
delivered Wednesday evening, However, he denied a recent report that
NIH would curtail its vaccine research.

“Use of protease inhibitors was strongly associated with the likelihood of
having a myocardial infarction [heart attack] and correlated with diabetes
mellitus and hyperlipidaemia.”

Lancet. 2002 Nov 30;360(9347)
– Holmberg SD, et al, Aids Researchers

“…In the abacavir-lamivudine-zidovudine [AZT] group, one death was
attributed to hypersensitivity reaction that occurred following
rechallenge with abacavir approximately three weeks after initiating study
treatment, and two were attributed to cardiac arryhthmia and myocardial
infarction [heart attack] occurring 30 to 35 weeks after initial study
treatment. ”

JAMA. 2001 Mar 7;285(9):1155-63
– Staszewski S, et al, Aids Researchers

Yup Anti-Viral medications are powerful drugs that have serious side effects
one of which for some of the drugs is a higher risk for hart disease. In
some groups of long term AIDS patients hart disease is the leading cause of
death that is true.

What you ignore is that these people would have died in the mid 90's with
the drugs. So you make the choice 10 or more years of life and the potential
for life shortening side effects or death. It was an easy choice for me I
chose to live and take the risk though others might choose differently.

I don't know anyone who did choose to avoid the anti-virals and who was at
my stage of AIDS when the PI's came onto the scene as a treatment for HIV
and AIDS and who are still alive today so it seems I made the correct
choice.

Gary Stein