Persons with human immunodeficiency virus (HIV) infection might be at risk
for ischemic cardiovascular disease (CVD). We reviewed the records of 16 HI
V-infected persons with proven CVD (8 cases of angina and 8 cases of myocar
dial 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 fa
ctors 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 nucleosid
e analogs (median, 190 weeks versus 130 weeks;P = .02). There was no differ
ence in the duration of exposure to protease inhibitors. Ischemic CVD occur
s in HIV-infected persons and appears to be most closely associated with tr
aditional risk factors for coronary artery disease (for example, hypertensi
on and hypercholesterolemia). Lower CD4(+) lymphocyte counts and duration o
f HIV infection might also be risk factors or markers for the development o
f ischemic CVD.