Cardiovascular Manifestation of HIV: Review

Abstract

HIV infection is a leading health problem across the entire world, including United States. Recent advances in medicine have led to a significant decline in mortality associated with HIV infection and hence increased life expectancy in HIV-infected individuals. Cardiovascular complications represent an increasingly important health concern in HIV-infected population especially after the introduction of anti-retroviral therapy. Numerous research studies have demonstrated the increased prevalence of cardiovascular disease in HIV infected individuals. The etiology of the preponderance of cardiovascular manifestations associated with HIV is still not well established. It may be attributed to virus itself, the effects of anti-retroviral medications; or altered immune mechanisms associated with the infection. The stratification of cardiovascular risk and cardiovascular monitoring in HIV patients poses a challenge to the physicians in the modern age. The cardiovascular lesions reported in HIV infection include pericardial disease with effusion and tamponade, myocarditis, dilated cardiomyopathy with left ventricular dysfunction, endocarditis, coronary artery disease, pulmonary hypertension, cardiac autonomic dysfunction and certain rare neoplasms. HIV infection in itself can be a potential risk factor for accelerated coronary artery disease. The advent of anti-retroviral therapy has witnessed an increased risk of metabolic syndrome, hyperlipidemia and insulin resistance in HIV patients on HAART. Thorough understanding of the course of cardiac related illnesses in HIV infection helps in early diagnosis, appropriate intervention and therapy. The following review overviews the cardiac abnormalities associated with HIV infection focusing on early diagnosis, therapy and prognosis.