Effect of highly active antiretroviral therapy on ischemic cardiovascular disease in patients with HIV-1 infection.

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Abstract
Sir—In their recently published article, David et al. [1] raised important concerns about the risk factors for ischemic cardiovascular disease (ICD). In particular, these investigators showed that ICD events are more common among patients with a lower CD4 lymphocyte count and among patients with more-prolonged exposure to nucleoside reverse-transcriptase inhibitors (NRTIs); they also showed that exposure to protease inhibitors (PIs) was not directly associated with a greater risk of development of ICD. However, the investigators did not rule out the possibility that longer duration of exposure to PIs might be related to increased risk for ICD.