WEDNESDAY, April 2 (HealthDay News) -- Two well-known HIV drugs, abacavir and didanosine, appear to increase the risk of heart attacks, European researchers reported Wednesday.

Based on that data, the U.S. Food and Drug Administration is now conducting a safety review of the potential risks of both drugs.

Many people with HIV take a combination of antiretroviral drugs, which include a protease inhibitor and a nucleoside reverse transcriptase inhibitor such as abacavir or didanosine. Concerns have been raised about the cardiovascular effects of long-term use of these drugs.

"We have investigated a number of drugs used to treat HIV patients for whether they are associated with an altered risk of having a heart attack," said lead researcher Dr. Jens D. Lundgren, from the University of Copenhagen in Denmark. "We have identified [that] two of those drugs were indeed associated with an increased risk of a heart attack."

The actual risk of having a heart attack when using these drugs varies with whether a patient already has underlying risk for heart attack, Lundgren added. For example, a patient who is at risk for having a heart attack will increase his or her risk by 38 percent by using either abacavir or didanosine, he said.

"However, if you have a very small underlying risk of heart attack, the risk will only be slightly increased," Lundgren said.

The report was published Wednesday in the online edition of The Lancet.

In the study, Lundgren's team collected data on 33,347 HIV patients who participated in the Data Collection on Adverse Events of Anti-HIV Drugs study (D:A:D). Specifically, the researchers looked for a connection between HIV medications and heart attack.

For commonly used drugs called nucleoside reverse transcriptase inhibitors such as zidovudine, stavudine or lamivudine, the researchers found no association with an increased risk for heart attack.

However, the nucleoside reverse transcriptase inhibitors abacavir and didanosine were associated with an increased rate of heart attack, the researchers found. For patients taking abacavir, there was a twofold increased risk for heart attack. For those taking didanosine, the increased risk was about 50 percent.

For patients who stopped using these drugs, their risk for heart attack decreased within six months, Lundgren's group found.

"For those patients who have an increased underlying cardiovascular risk, then our suggestion is that these patients should consider whether there are other safer alternatives to these drugs," Lundgren said. "If there are safer alternatives, then patients should consider switching to those."

In a letter published in the same journal issue, GlaxoSmithKline, the maker of abacavir, said that their own analysis of 54 studies found no increase in the risk of heart attack from the drug.

GlaxoSmithKline spokesman Dr. Didier Lapierre wrote, "We did not find a result consistent with that of D:A:D... GSK takes the D:A:D finding seriously and is committed to understanding these data more fully and to communicating openly with treating physicians and regulatory agencies globally."

Didanosine is manufactured by Bristol-Myers Squibb.

Based on the data from D:A:D, the FDA said last week that it was conducting a safety review of both drugs.

"FDA continues to evaluate the overall risks and benefits of abacavir and didanosine. This evaluation may result in the need to revise labeling for the products. Until this evaluation is complete, health-care providers should evaluate the potential risks and benefits of each HIV-1 antiretroviral drug their patients are taking, including abacavir and didanosine," the agency said in a statement.

One expert thinks it's more important for patients to have their HIV under control; then they can worry about potential cardiovascular side effects.

"This is a surprising and provocative finding," said Dr. James Sosman, an associate professor of medicine at the University of Wisconsin School of Medicine. "We have not seen cardiovascular problems associated with abacavir."

Sosman noted that the use of antiretroviral drugs has replaced concerns about serious opportunistic infections in HIV patients with concerns about less serious risks like cardiovascular disease and diabetes.

"The most important thing for HIV patient is to control their HIV," Sosman said. "If they have excellent control with abacavir or didanosine, then you look for options to limit other risk factors. Patients not on HIV therapy have a higher risk of developing heart disease than people on HIV therapy," he said.

More information

For more on HIV, visit the U.S. National Institute of Allergy and Infectious Diseases.

FRIDAY, March 28 (HealthDay News) -- Giving birth early seems to increase a woman's risk of having high cholesterol later, a new study shows.

And that raises the chances of heart disease even further down the line for these women, the researchers added.

The findings were presented Thursday at the Society for Gynecologic Investigation annual meeting, in San Diego.

"Total cholesterol and LDL cholesterol were elevated in women who'd had a preterm birth, before 34 weeks," said study author Janet Catov, an assistant professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine.

Catov said it's hard to know yet whether there's something in the pregnancy or preterm delivery that triggers the high cholesterol, or if it's the high cholesterol that may have something to do with the preterm delivery. She did note that "very early in pregnancy, women with preterm birth have elevated lipids, which may be exacerbated in pregnancy."

Another recent study found that women with very low levels of cholesterol were also at risk of preterm birth, but Catov said this study showed that women on the very high end of cholesterol levels also went on to give birth prematurely.

"Perhaps there's a normal range, and if you're higher or lower, it could be a problem," she said.

In the current study, Catov and her colleagues compared 47 women who'd had a preterm birth, defined as giving birth before 37 weeks of gestation, to 104 women who gave birth to full-term infants. Most of the women in the preterm group gave birth before 34 weeks of gestation.

Women who had other chronic medical conditions, such as preeclampsia or a baby with signs of growth restriction, were excluded from the study.

Blood samples were taken an average of 7.4 years after delivery.

Women who'd given birth before 34 weeks of gestation had the highest levels of total cholesterol at 202.6 mg/dl. Women who gave birth between 34 and 37 weeks had levels of 190.1 mg/dl, and women who carried their babies to term had levels of 180.1 mg/dl.

After adjusting for race, smoking history and body mass index, the researchers found that women who gave birth prematurely had a 2.3 times greater risk of developing cholesterol levels above 240 mg/dl, a level considered high risk by the American Heart Association.

Additionally, women who'd had a preterm birth were 3.3 times more likely to have elevated LDL -- the "bad" cholesterol -- than women who gave birth to full-term babies.

"What this study tells us is that a woman's previous medical history, particularly conditions that happen during pregnancy, may be a clue to her later heart disease risk," said Dr. Nieca Goldberg, director of the New York University Medical Center's Women's Heart Program.

"I would advise a woman who's had a preterm birth and who now has high cholesterol to have her cardiac risk factors evaluated at regular intervals, at least with a yearly physical," said Goldberg.

While Catov said these findings need to be duplicated in a larger study before any specific guidelines or recommendations can be made, she said it's a good idea to "keep your doctor apprised of your medical conditions and preterm births or other adverse pregnancy outcomes, and keep up to date with recommended screenings."

More information

To learn more about cholesterol and how to lower your levels, visit the American Heart Association  .

WEDNESDAY, March 26 (HealthDay News) -- New research suggests that a child's problems forming relationships and being accepted by friends are more likely to contribute to anxiety and depression than vice versa, particularly during the transition from adolescence into young adulthood.

The study, conducted by researchers at the universities of Vermont and Minnesota, found that young people who initially had more "internalizing" problems such as anxiety and depression were more likely to have those problems in adolescence and young adulthood. Those who were socially competent at the start, though, were socially competent as they grew up.

In addition, the study -- published in the March/April issue of Child Development -- found evidence of spillover effects, where social problems contributed to increasing internalizing symptoms over time.

"Overall, our research suggests that social competence, such as acceptance by peers and developing healthy relationships, is a key influence in the development of future internalizing problems such as anxiety and depressed mood, especially over the transition years from adolescence into young adulthood," study lead author Keith Burt, assistant professor of psychology at the University of Vermont, said in a prepared statement. "These results suggest that although internalizing problems have some stability across time, there is also room for intervention and change. More specifically, youth at risk for internalizing problems might benefit from interventions focused on building healthy relationships with peers."

The study followed 205 individuals from middle childhood (ages 8 to 12) into young adulthood over 20 years. The researchers used detailed interviews with participants and reports from their parents, teachers and classmates to create measures of so-called internalizing problems (anxiety, depressed mood, being withdrawn) and social competence (how well one functions in relation to other people, particularly with respect to getting along with others and forming close relationships). They then examined how these measures related to each other over time.

Children who were less socially competent in childhood were more likely to have symptoms of anxious or depressed mood in adolescence, according to the findings. Similarly, young people who were less socially competent in adolescence were at greater risk for symptoms of anxiety and depression in young adulthood. The results were generally the same for males and females.

The findings remained the same when the researchers accounted for some other possible explanations, such as intellectual functioning, the quality of parenting, social class, and such problems as fighting, lying and stealing.

More information

The U.S. National Institute of Mental Health has more about child and adolescent mental health.

WEDNESDAY, March 19 (HealthDay News) -- The benefits of folate for women in preventing birth defects are well known, but new research suggests the nutrient also boosts sperm health.

Men with relatively low levels of folate had increased risks for sperm containing either too few or too many chromosomes, according to researchers at the University of California, Berkeley. These types of deficiencies can cause birth defects and miscarriages, the experts noted.

Folate is one of the B vitamins and is found in leafy green vegetables, fruit and beans, chickpeas and lentils. By law, breads and grains sold in the United States are also now specially fortified with added folate to help ward off birth defects.

"We looked at sperm to find different kinds of genetic abnormalities," said lead researcher Brenda Eskenazi, a professor of maternal and child health and epidemiology and director of the Center for Children's Environmental Health at Berkeley's School of Public Health. "The abnormalities we looked at here were having too few or too many chromosomes," she said.

Normally, human sperm have 23 pairs of chromosomes. "In sperm you normally have one of each, but sometimes there are two and sometimes there are none of a particular chromosome," Eskenazi said.

If a normal egg was fertilized with one of these abnormal sperm, it could result in a birth defect, such as Down's syndrome, Eskenazi said. "This can also result in an increase in miscarriage," she said.

The researchers looked at three specific chromosomes: X, Y and 21. "We saw an association between [male] folate intake and how many abnormal sperm there were, in terms of the chromosome number for these three different chromosomes," Eskenazi said.

The study findings are published in the March 20 issue of the journal Human Reproduction.

In the study, Eskenazi's group analyzed sperm from 89 healthy men. In addition, the researchers asked the men about their daily consumption of zinc, folate, vitamin C, vitamin E and beta-carotene.

The researchers found that men who had the highest intake of folate had the lowest incidence of sperm abnormalities. In fact, men who had the highest intake of folate -- 722 to 1,150 micrograms a day -- had a 20 percent to 30 percent lower frequency of several types of sperm abnormalities, compared with men who consumed less folate.

Up till now, birth-defect researchers have typically focused on women's diet in the period around conception, Eskenazi said. "Based on these data, maybe men, too, need to consider their diet when they are considering fathering a child," she said.

Although this study doesn't conclusively prove a link between folate and chromosomal abnormality, Eskenazi advises men who are thinking of becoming fathers to increase their folate intake, perhaps with a supplement or a multivitamin containing folate.

This isn't the first study to find a link between diet and sperm health. A report published last year in Human Reproduction found that women who ate beef seven or more times per week tended to produce sons with lowered sperm counts, perhaps due to the effects of hormones or pesticides on developing testes.

One expert agrees that healthy eating is linked to having healthy babies -- even for men.

"This is another common-sense article that says good nutrition is associated with a better reproductive outcome," said Dr. Jamie Grifo, director of reproductive endocrinology at New York University Medical Center.

Grifo noted that rates of abnormal sperm seen in the Berkeley study were four to six per 1,000, which means that men with poor nutrition still had more than 99 percent normal sperm.

"Even though this may be the case, don't smoke, drink modestly, eat healthy unprocessed food and take your vitamins," Grifo advised prospective fathers.

More information

For more on infertility, visit the American Society of Reproductive Medicine  .