Cardiovascular Disease in the Setting of Human Immunodeficiency Virus Infection

Abstract

BACKGROUND Since the introduction of Antiretroviral Therapy (ART), the life expectancy and health quality for patients infected with Human Immunodeficiency Virus (HIV) have significantly improved. Nevertheless, as a result of not only the deleterious effects of the virus itself and prolonged ART, but also the effects of aging, cardiovascular diseases have emerged as one of the most common causes of death among these patients. OBJECTIVE The purpose of this review is to explore the new insights on the spectrum of Cardiovascular Disease (CVD) in HIV infection, with emphasis on the factors that contribute to the atherosclerotic process and its role in the development of acute coronary syndrome in the setting of infection. METHODS A literature search using PubMed, ScienceDirect and Web of Science was performed. Articles up to Mar, 2017, were selected for inclusion. The search was conducted using MeSH terms, with the following key terms: [human immunodeficiency virus AND (cardiovascular disease OR coronary heart disease) AND (antiretroviral therapy AND (cardiovascular disease OR coronary heart disease))]. RESULTS Clinical cardiovascular disease tends to appear approximately 10 years before in infected individuals, when compared to the general population. The pathogenesis behind the cardiovascular, HIV-associated complications is complex and multifactorial, involving traditional CVD risk factors, as well as factors associated with the virus itself - immune activation and chronic inflammation - and the metabolic disorders related to ART regimens. CONCLUSION Determining the cardiovascular risk among HIV-infected patients, as well as targeting and treating conditions that predispose to CVD, are now emerging concerns among physicians.