What are the potential cardiovascular risks associated with HIV treatment?
The protease inhibitors amprenavir/fosamprenavir with or without ritonavir and lopinavir with ritonavir have the strongest association with risk of AMI, although saquinavir and nelfinavir do not appear to be associated with MI.1201,1202 The nucleoside reverse-transcriptase inhibitors didanosine and abacavir also are associated with risk of AMI.1202 Other agents, such as nonnucleoside reverse- transcriptase inhibitors (nevirapine and efavirenz), entry inhibitors, and integrase inhibitors, do not appear to be associated with an increased risk of IHD. Despite the increase in prevalence of IHD among patients with HIV, the absolute increase in incidence of AMI is relatively low, and overall mortality does not appear to be increased.1198,1203