HIV causes structural heart disease, according to research presented at EuroEcho-Imaging 2013 by Dr Nieves Montoro from Madrid, Spain. The findings support the introduction of cardiovascular screening in all HIV patients, particularly those with a positive blood viral load.
Dr Montoro said: “It is well known that patients with HIV have a high incidence of structural heart disease (mainly diastolic dysfunction and pulmonary hypertension) as measured by echocardiography but the reason is not clear. We decided to conduct a study to evaluate whether the stage of HIV or the detectable blood viral load were related to the degree of heart disease.”
The study found that patients with a positive blood viral load had a significantly higher incidence of structural heart disease than those with an undetectable load. In fact, having a detectable blood viral load nearly doubled the prevalence of heart disease, suggesting that HIV itself might be an independent causal agent.
Dr Montoro said: “Our study shows an association between the presence of the virus in the blood and cardiac disease. These findings open the door to the hypothesis that HIV is involved in the aetiology of cardiac damage. It is known that HIV can produce a pro-inflammatory response and this could involve the heart too. We are conducting further studies to test this idea.”
She continued: “Because of the high incidence of cardiac problems in our study (almost 50%) we think that all HIV patients with dyspnoea should undergo a transthoracic echocardiogram to check for structural heart disease. This is a non-invasive, cost-effective and accessible diagnostic test. Furthermore, patients with a positive blood viral load are at nearly twice the risk of structural heart disease and they should receive an echocardiogram whether they are symptomatic or not.”
She concluded: “Detecting cardiac problems in HIV patients sooner using a simple diagnostic tool like echocardiography will enable us to treat them in the very early stage of the heart damage and improve their prognosis. Patients found to have a detectable blood viral load and/or structural heart disease should have closer follow up by a cardiologist and their HIV specialist doctor.”
EuroEcho-Imaging 2013 is the official annual meeting of the European Association of Cardiovascular Imaging (EACVI), a registered branch of the European Society of Cardiology (ESC). It takes place during 11-14 December in Istanbul, Turkey, at the Istanbul Lutfi Kırdar Convention & Exhibition Centre (ICEC).
