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HIV patients may be at risk of heart problems when taking protease inhibitor drugs

ROCHESTER, Minn. -- A widely-used class of drugs that keep the HIV-virus infection from progressing to AIDS may cause serious and potentially lethal heart rhythm disturbances in some patients. The finding of a Mayo Clinic-led investigation appears in the current edition of The Lancet (http://www.thelancet.com/home).

In collaboration with colleagues from the HIV Program of Hennepin County Medical Center, Minneapolis; the University of Minnesota, Minneapolis, and University of Wisconsin, Madison, the Mayo Clinic researchers made the discovery about a class of prescription drugs known as "HIV protease inhibitors." Drugs in this class go by the generic names of lopinavir, nelfinavir, indinavir, ritonavir and saquinavir. Brand names include Kaletra, Viracept, Crixivan, Norvir and Fortovase.

The researchers emphasize that the drugs' therapeutic benefits are still greater than the risk of heart problems linked to their use. They urge physicians to apply this new finding by following their patients more closely over the long term, and by looking specifically for heart rhythm irregularities in vulnerable individuals. They encourage physicians to be especially thorough when performing medical exams, and in taking patient histories to be alert for signs of heart rhythm disturbances.

Implications of the Findings

"In no way does it mean patients shouldn't receive protease inhibitors," says Andrew Badley, M.D., associate director of Mayo Clinic's Program in Translational Immunovirology and Biodefense. "It just means clinicians need to be aware of this new risk we've found, and act accordingly. Worldwide, tens of thousands of people are taking protease inhibitors, and the numbers who experience these unexpected side effects are very low -- much less than 1 percent."

Co-investigator Michael Ackerman, M.D., Ph.D. agrees that the benefits of the drugs far outweigh the risks. "Our findings
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Contact: Bob Nellis
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
17-Feb-2005


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