Cardiovascular disease in patients with HIV

Trends Cardiovasc Med. 2017 Nov;27(8):558-563. doi: 10.1016/j.tcm.2017.06.005. Epub 2017 Jun 12.

Abstract

With the progressive increase in life expectancy of HIV-positive patient, thanks to "highly active antiretroviral therapy" (HAART), new comorbidities, and especially cardiovascular diseases (CVDs) are emerging as an important concern. An increased risk of coronary artery disease, often in a younger age, has been observed in this population. The underlying pathophysiology is complex and partially still unclear, with the interaction of viral infection-and systemic inflammation-antiretroviral therapy and traditional risk factors. After an accurate risk stratification, primary prevention should balance the optimal HAART to suppress the virus-avoiding side-effects-the intervention on life-style and the treatment of traditional risk factors (hypertension, dyslipidemia, and diabetes). Also the management after a cardiovascular event is challenging: revascularization strategies-both percutaneous and surgical-are valuable options, keeping in mind the higher rates of recurrent events, and caution is essential to avoid drug-drug interactions. Large evidence-based data on HIV-infected patients are still lacking, and recommendations often follow those of general population. Therefore we performed a comprehensive evaluation of the literature to analyze the current knowledge on CVD's prevalence, prevention and treatment in HIV-infected patients.

Publication types

  • Review

MeSH terms

  • Antiretroviral Therapy, Highly Active / adverse effects
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / therapy
  • Cardiovascular Diseases / virology
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Long-Term Survivors*
  • Humans
  • Life Expectancy
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome