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Clinical trial addresses HIV and cardiovascular risks
by Matt Simonette

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Researchers at two area universities are among those participating in a nationwide clinical trial focused on HIV-related cardiovascular disease.

University of Illinois at Chicago and Northwestern University are two local sites of the six-year clinical trial, known as the Randomized Trial to Prevent Vascular Events in HIV ( REPRIEVE ). About 6,500 subjects across the country are expected to participate in the study, which hypothesizes that statins should reduce plaque development and improve cardiovascular outcomes in patients with HIV.

Patients with HIV are one-and-a-half to two times as likely to die of cardiovascular disease as individuals without it, according to Stockton Mayer, M.D., an assistant professor of medicine at University of Illinois at Chicago College of Medicine.

"There are a lot of hypotheses for why people with HIV are at increased risk," Mayer said. "Some think there is a component of what's called immune activation. People with HIV and chronic infection have a chronic stimulus of their immune system, which leads to inflammatory reaction and plaque-buildup in their coronary arteries, which in turn lead to heart attacks."

Some researchers are concerned that HIV medication might also contribute to lipid abnormalities ultimately increasing risk for cardiovascular disease. Mayer further noted that many patients who are on anti-retroviral therapies can also end up at increased risk for other chronic illnesses as well.

"As we get more experience with anti-retrovirals, and we get more mechanisms to control the virus, and to extend [patients'] lifespans, it becomes more important to look at some of these other things that are causing premature death in our HIV-positive patients and learning to control those for long, healthy lives," Mayer said.

Researchers are seeking participants in the REPRIEVE study, primarily HIV-positive men and women aged 40-75 who are at low-to-moderate risk for cardiovascular disease. They should have been on anti-retroviral therapy for at least six months with a suppressed viral load.

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