Question
Should I stop using abacavir if I am worried about a heart attack?
29 May 2008. Related: All topics, Side effects, Stopping treatment.
Answer
Use of abacavir, whether you are already on treatment or starting for the first time, depends on two important factors: your current risk of having a heart attack, and your alternative treatment options.
The D:A:D study found that the impact of abacavir was most significant in patients who had a high underlying risk of heart disease. For people with highest risk, then switching is probably a good idea if you have other options.
Your risk of having a heart attack is estimated by your doctor putting a few of your lab results into an online risk calculator (usually Framingham). See here or here.
Secondly, even if this risk is high, you need to have an alternative drug to switch to. This will depend on your previous treatment history.
Everything in HIV has to be individualised to your specific health and history, and this is something to talk about with your doctor. Please do not think about stopping abacavir without your doctors knowledge and support. The absolute risk of heart disease is still generally low for most people but you need to know that your HIV combination is potent enough to keep HIV under control.
The link between abacavir and an increased risk of heart attack in the D:A:D study was new and unexpected. It was reported at the Retrovirus conference in February, and we included this in an article in HIV Treatment Bulletin.
We also published the Q&A statement from the D:A:D researchers in terms of what this means for people already using abacavir.
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