HIV May Cause Structural Heart Disease

Structural heart disease directly linked to detectable HIV viral count

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Structural heart disease is very common in HIV patients. It's possible that the conditions are directly related.

A recent study suggested that HIV might cause structural heart disease — a condition in which heart failure is caused by a defect in the physical functioning of the heart.

The researchers found that HIV patients with a detectable amount of virus in their blood were twice as likely to have structural heart disease compared to HIV patients with an undetectable amount of virus in their blood.

"Monitor your heart health regularly if you have HIV."

The lead author of this study was Nieves Montoro, MD, from the Department of Cardiology at University Hospital La Paz in Madrid, Spain.

The study included 65 HIV patients who had previously been diagnosed with dyspnea (shortness of breath).

All of the participants were classified as level II or above on the New York Heart Association (NYHA) Functional Classification scale — a scale that categorizes a patient's level of heart failure from levels I to IV. A level II classification meant that a patient had mild symptoms and was slightly limited in usual everyday activity.

The average age of the participants was 48 years old, and 63 percent were male.

The researchers determined the stage of each patient's HIV by measuring the viral load (amount of virus in the blood) and the CD4 count (type of blood cells that virus attaches itself to).

Then, all the participants were given a transthoracic echocardiogram to determine how well each structure of the heart was functioning. A transthoracic echocardiogram is a test that creates a moving picture of the heart as it is beating.

In addition, the researchers assessed heart disease risk factors such as hypertension (high blood pressure), diabetes, smoking status, dyslipidemia (abnormal amount of fat in the blood) and kidney failure.

The findings showed that 47 percent had some form of structural heart disease.

Half of the participants were classified as level II on the NYHA scale, 32 percent were classified as level III and 18 percent were classified as level IV.

Level III meant that a patient was generally limited in usual and unusual everyday activities and was only comfortable when resting. Level IV meant that the patient was severely limited in all activities and experienced symptoms even while resting.

The researchers discovered that 75 percent of the patients with a detectable viral load had some type of structural heart disease versus only 43 percent of the patients who had an undetectable viral load.

A patient's NYHA level and type of HIV medication did not affect the incidence of structural heart disease.

This study also revealed that 65 percent of the participants had AIDS.

However, Dr. Montoro and team found that the likelihood of having structural heart disease was independent of gender, age, heart disease risk factors and whether or not the patient had AIDS.

These researchers believe that HIV may be independently associated with the cause of structural heart disease because having a detectable viral load doubled the number of cases of heart disease.

Overall, the research team suggested that HIV patients with dyspnea should be closely and regularly monitored for structural heart disease regardless of being symptomatic or not, especially patients with detectable viral loads.

This study was presented on December 11 at EuroEcho-Imaging 2013, the annual meeting of the European Association of Cardiovascular Imaging, a registered branch of the European Society of Cardiology.

Review Date: 
December 18, 2013
Last Updated:
February 25, 2014