In an article published in the Archives, Butt et al1 reported an association between human immunodeficiency virus (HIV) infection and heart failure in a retrospective cohort of veterans with no coronary heart disease (CHD) at the baseline. In addition, the magnitude of the association was even stronger for HIV infection than for traditional risk factors, except hypertension and diabetes.
The authors have used previously validated criteria to define heart failure, CHD, HIV infection, hypertension, and diabetes,2 based on codes of the International Classification of Diseases, Ninth Revision (ICD-9) attributed to inpatient and/or outpatient diagnoses. As reported in previous studies, there was a reasonable agreement of these definitions with medical records and/or laboratory test–based diagnoses.3 Hypertension is one of the most important risk factors for heart failure, and adherence to lipid-lowering antihypertensive drugs is inversely associated with alcohol consumption and illicit drug use, risk factors for HIV infection.4