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Editorials

Highly active antiretroviral therapy

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7504.1341 (Published 09 June 2005) Cite this as: BMJ 2005;330:1341
  1. Filip Moerman, head of HIV/STI outpatient department (fmoerman@itg.be),
  2. Alfons Van Gompel, associate professor,
  3. Jan Nimmegeers, consultant cardiologist,
  4. Johan Moerman, general medical officer
  1. Institute of Tropical Medicine, Unit of HIV/AIDS and STIs, Nationalestraat 155, 2000 Antwerp, Belgium
  2. Institute of Tropical Medicine, Unit of HIV/AIDS and STIs, Nationalestraat 155, 2000 Antwerp, Belgium
  3. Academic Hospital Saint-Lucas, 9000 Ghent, Belgium
  4. Bromeliastreet 91, 9040 Ghent, Belgium

Cardiovascular risk needs to be assessed before starting treatment

In the industrialised world the availability of highly active antiretroviral treatment (HAART) for advanced HIV-1 disease has dramatically improved patients' life expectancy.1 However, an unfailing lifelong commitment to antiviral drugs is expected. Furthermore, recent evidence is mounting that cardiovascular and cerebrovascular accidents might seriously impair the health of infected individuals,2 and the resulting morbidity and mortality have put an end to the unlimited optimism that was associated with the beginning of the HAART era. Here we look at the importance of assessing and targeting the risk of cardiovascular disease before starting HAART and consider what effect this risk has on determining the best time to start treatment.

For people infected with HIV-1, HAART may substantially increase the risk of cardiovascular mortality compared with non-infected individuals or …

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