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What is the connection, if any, between sudden cardiac death andpeople with HIV/AIDS? And can that knowledge help prolong theirlives? In a comprehensive, 10-year UCSF study, researchers found patientswith HIV/AIDS suffered sudden cardiac death at a rate four timeshigher than the general population. "As part of my ongoing research in 2010, we were looking at everyinstance of sudden death in San Francisco," said first author ZianH. Tseng, MD, an electrophysiologist and an associate professor ofmedicine in the UCSF Division of Cardiology. "I noticed that manyof these cases involved individuals with HIV infection who were dying suddenly. I wondered if there was somesort of connection there." He posed this question to Priscilla Hsue, MD, a UCSF associateprofessor of medicine and the director of the HIV Cardiology Clinicat San Francisco General Hospital and Trauma Center (SFGH), who isone of a few cardiologists in the country who specializes in HIV.To her knowledge, no one had ever explored the link between HIV andsudden death, and that is when they began collaborating on thisresearch. In a paper scheduled to be published May 15 in the Journal of the American College of Cardiology, Tseng, Hsue and other researchers conducted a retrospective studyof 2,860 HIV patients from April 2000 to August 2009 at SFGH's Ward86, the first HIV/AIDS-specialized clinic, to comprehensivelycharacterize all deaths. They studied medical records, deathcertificates, paramedic reports, and interviews with familymembers, doctors, and other clinicians. Sudden Cardiac Death and HIV/AIDS During that period, eight percent died during an average of 3.7years of follow up. Cardiac-related deaths accounted for 15 percentof overall mortality. Of that group, 86 percent died of suddencardiac death. "To put that in context, we're able to compare the rate of suddendeath in this population with the overall San Franciscopopulation," Tseng said. "So adjusted for age, race, demographics,and other variables, the rate of sudden death in the HIV populationis more than four times higher than the general population." "The fact that the vast majority of cardiac deaths were sudden issurprising and implies that we as clinicians need to be aware ofthis potential health issue among patients with HIV," Hsue added."Our findings also highlight many things that we still don't knowabout HIV and sudden death. Did these individuals die ofunrecognized coronary artery disease ? What can we be doing as clinicians to identify patients at riskand to intervene beforehand?" Categorizing Sudden Cardiac Death By 2003, sudden cardiac death made up the largest number ofnon-AIDS deaths among HIV-positive patients in San Francisco. Thesedeaths were largely among individuals with evidence ofwell-controlled HIV disease. Researchers used well-published criteria for retrospectivelyidentifying death as either HIV-related or sudden death-related. Ifthere was any doubt, they classified sudden death as an HIV death. "In other words, for someone with a CD4 (T-cell) count less than 50who died suddenly, we classified that as an HIV death, rather thana sudden death because of the profound immunodeficiency," Tsengsaid. More than 17,000 people with AIDS died in 2009 worldwide, and more than 619,000 people have diedsince the epidemic began. Still, the number of people living withHIV continues to rise. More than 1.2 million people in the UnitedStates are HIV-positive, according to the U.S. Department of Health& Human Services. "Now that HIV-infected individuals are living longer with thebenefit of antiretroviral therapy, non-AIDS conditions are becomingincreasingly important and at the top of this list iscardiovascular disease," Hsue said. Researchers believe HIV changes the electrophysiology of the heartin a way so pronounced that it causes conduction abnormalities. Andmany HIV medications can throw off the heart's electrical cycle byprolonging the QT interval, which increases the risk of suddendeath. These and other variables could be contributing factors. "Acknowledging the limitations of a retrospective analysis, what'sexciting about this study is that it opens up many relatedquestions we can ask in future studies, such as which high-riskpatients might benefit from defibrillator implantation?" Tsengsaid. Tseng is in the middle of a prospective citywide study on suddencardiac death, including studying HIV patients and monitoring theirprogress. Additional References Citations. I am an expert from automobile-glassreplacement.com, while we provides the quality product, such as China Auto Plastic Fastener , China Mirror Mounting Bracket, Solar Guard Window Film,and more.
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