People with HIV and heart failure had low guideline-directed medical therapy scores (mean 30%), suggesting suboptimal intensity of HF care, with cardiology clinic attendance associated with higher GDMT scores.
The majority of people with HIV and systolic heart failure were prescribed some GDMT, but overall therapy intensity was low.
Less than half of people with HIV and systolic heart failure attended a cardiology clinic visit in the year after diagnosis.
Cardiology clinic attendance was independently associated with higher GDMT scores.
Diabetes mellitus and prior myocardial infarction were associated with higher GDMT scores.
Older age and severe renal disease were independently associated with lower GDMT scores.
The study population was predominantly Black, reflecting the focus of the PATHWAYS study on underrepresented racial and ethnic minorities with HIV.
This research suggests that people living with HIV who also have heart failure are not receiving optimal medical treatment for their heart condition. The study looked at 451 patients with HIV and systolic heart failure (a type of heart failure where the heart muscle is weakened) and found that while most patients (about 86%) were prescribed at least some heart failure medication, the overall intensity of treatment was low — averaging only 30 out of a possible 100 points on a therapy score scale. Less than half of patients saw a heart specialist (cardiologist) in the year after their heart failure diagnosis. The research identified several factors linked to better or worse treatment. Patients who visited a cardiologist received more complete heart failure therapy, as did those with diabetes or a prior heart attack. On the other hand, older patients and those with severe kidney disease received less intensive therapy, which may partly reflect medical caution given the risks of certain medications in these groups. The study was conducted within a cohort that was nearly entirely Black (96.6%), highlighting that these findings are particularly relevant to a population already facing health disparities. This research suggests that improving access to cardiology care for people living with HIV and heart failure could be an important strategy for closing treatment gaps. People with HIV already have a higher risk of developing heart failure than the general population, making adequate heart failure treatment especially important for this group. The findings point to a need for better coordination between HIV care providers and heart specialists to ensure patients receive guideline-recommended therapies.
Cutshaw M, Clare R, Chiswell K, Hofmann P, Pettit A, Meissner E, et al.. (2026). Heart failure among people with HIV: prescription of guideline-directed medical therapy.. HIV research & clinical practice. https://doi.org/10.1080/25787489.2026.2728496