High Risk of Sudden Cardiac Death for People Living with HIV/AIDS

By: Jonathan J. Pena, MSW, Licensed Clinical Social Work Associate (LCSWA)

Longevity is the end result that many people strive towards when aiming at leading and living a healthy life. People living with HIV/AIDS (PLWHAs) have that same goal and with antiretroviral medication, longevity has become a materialized reality. However, PLWHAs are twice as likely to experience sudden cardiac death.[1] 

Sudden cardiac death happens without any warning rather quickly with loss of consciousness at a physical triggered reaction. Death is often the result that follows. Research indicates that autopsies from HIV positive individuals found that the heart muscle was damaged. This occurrence is called fibrosis and a key indicator as to why sudden cardiac deaths are more prevalent within this population.[2] 

Dr. Zian Tseng, a lead researcher and electrophysiologist at the University of California, expressed that “deaths caused by fatal arrythmias among HIV patients are 87% higher than among the general population.”[3] High levels of inflammation are the driver in this alarming statistic and thus people living with HIV/AIDS need to be vigilant and have regular conversations with their doctors because inflammation can also be found in other areas like lymph nodes, the stomach and liver.[4] 

Photo Source: Cleveland Clinic

These finding were pulled from a study where Dr. Tseng and colleagues looked at unexpected deaths from people with HIV in the San Francisco area from 2011 until 2016. The team examined a total of 610 autopsies from this time period and discovered that 109 on those were cardiac arrest that occurred out of a hospital setting. From this set, 48 showed indications of sudden cardiac death and 22 from heart disease and arrhythmia. Additionally, the study showed deaths not related to cardiac distress which included diabetic ketoacidosis, kidney failure, bleeding and infections.[5] 

Research results like this put the lived experiences of PLWHAs into perspective. This is especially true for Long-Term Survivors.

Tez Anderson, Executive Director of Let’s Kick Ass-AIDS Survivor Syndrome, expressed: “Reading the reports on increased sudden cardiac death reminds us of how tenuous life is, especially for people living with HIV and AIDS for decades. It's something we learned very early in life and remains the leitmotif of survivors' lives. We've long known increased inflammation takes a toll on our bodies, even when our viral load is undetectable. The studies do not say it, but I imagine the length of time since HIV infection is a factor. This information is not new. I've known too many older adults with HIV who have died from fatal heart attacks. These studies point out the need for more studies on older adults with HIV and prevention intervention.”

Anderson statement speaks to how longevity within HIV positive populations still requires the same level of attention and vigilance as it did when the epidemic began. Antiretroviral medication changed the landscape in HIV/AIDS treatment and as a result PLWHAs now can live a longer life. However, living a longer and healthier life is the endgame. Due to its nature, the virus wreaks havoc on the body and even with viral suppression via medication, the virus continuously attacks and weakens essential organs in the backdrop. Additionally, while antiretroviral medication is lifesaving, the medication itself is taxing on the body and vital organs from the toxicity that needs to be continuously flushed out by our body’s defenses. 

So, as Anderson expressed, “what can we do about it?” What we can do is continue research and learn about the virus as we have since the epidemic began. 

The results of modern medicine have open up the possibility of longevity for PLWHAs and that fight needs to continue towards a cure. However, we need a greater understanding of how the virus affects long term survivors and how we can gain a handle the negative consequences of   inflammation. On a more micro-level, PLWHAs need to continue being an active participant in their treatment. Now more than ever, regular doctor visits are vital as well as honest and open conversations about the level of care that are needed for a long and healthy life. Stay invested and vigilant as strive to put an end to this virus.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

[1] Reinberg, S., (2021). Living with HIV Raises Odds for Sudden Cardiac Death. U.S News. Retrieved from: https://www.usnews.com/news/health-news/articles/2021-06-17/living-with-hiv-raises-odds-for-sudden-cardiac-death.

[2] Reinberg. Living with HIV Raises Odds for Sudden Cardiac Death.

[3] Reinberg. Living with HIV Raises Odds for Sudden Cardiac Death.

[4] Reinberg. Living with HIV Raises Odds for Sudden Cardiac Death.

[5] Reinberg. Living with HIV Raises Odds for Sudden Cardiac Death.