Ischemic cardiovascular disease in persons with human immunodeficiency virus infection

Persons with human immunodeficiency virus (HIV) infection might be at risk for ischemic cardiovascular disease (CVD). We reviewed the records of 16 HIV-infected persons with proven CVD (8 cases of angina and 8 cases of myocardial infarctions). This represents 1.7% of HIV-infected persons seen at our institution from 1 April 1999 through 25 April 2000. In comparison with 32 HIV-infected age- and sex-matched controls, case patients had more risk factors for CVD (median number of risk factors for CVD, 3 versus 1;), lower P < .001 nadir CD4(+) lymphocyte counts (median, 101 cells/mm(3) versus 278 cells/mm(3); P = .02), and a longer duration of prior exposure to nucleoside analogs (median, 190 weeks versus 130 weeks;P = .02). There was no difference in the duration of exposure to protease inhibitors. Ischemic CVD occurs in HIV-infected persons and appears to be most closely associated with traditional risk factors for coronary artery disease (for example, hypertension and hypercholesterolemia). Lower CD4(+) lymphocyte counts and duration of HIV infection might also be risk factors or markers for the development of ischemic CVD.