Heart attacks linked with antiretroviral treatment

New research has helped to explain why patients being treated with antiretroviral drugs for HIV experience a greater incidence of heart attacks. The research was presented by doctors and researchers from the School of Medicine and Medical Sciences at University College Dublin, the Mater Misericordiae University Hospital in Dublin and the Royal College of Surgeons in Ireland at the Retroviral Conference in Montreal, Canada, on 11 February.

Antiretroviral medications are used to treat a range of infections such as HIV. The new research was based on a major international study that was published in 2008 which showed that HIV patients being treated with antiretroviral drugs have a higher incidence of heart attacks than patients being treated with different drugs.

Doctors at the Royal College of Surgeons in Ireland built on the 2008 study by creating a test to measure platelet activity in the blood of HIV patients. Platelets are essential for external blood clotting when the skin is cut, but if they over activate or mutate inside blood vessels, they can cause internal blood clots, leading to heart attacks.

Results showed that HIV patients taking antiretroviral drugs are more susceptible to heart attacks because the drugs affect the platelets. Why this happens has not yet been established, but the findings pave the way for further research towards improved antiretroviral treatment for HIV patients.

"These findings will significantly affect the management of patients with HIV and have important implications for the treatment of HIV worldwide," says Dr Paddy Mallon, consultant in infectious diseases at the Mater Misericordiae University Hospital in Dublin and a lecturer in medicine at University College Dublin, who led the group researching drug toxicities in HIV.

"The international research published last year showed the link between antiretroviral treatments and increased risk of heart attacks but not the reason why. We have now demonstrated that the use of certain drugs for HIV has a direct effect on platelets within the blood. The results provide invaluable information to help in the search for safe, long term therapies for HIV infection."

Professor Dermot Kenny from the Royal College of Surgeons in Ireland, whose group developed the new test, said that the results demonstrated the value of translational research. "Because of our close collaboration we have seen how the novel diagnostics developed in our lab can move rapidly into the clinic in Ireland. We plan to extend this research to other HIV centres internationally."

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