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Coronary heart disease in HIV-infected patients

Marshall J Glesby1

  • 1Division of International Medicine and Infectious Diseases, Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA. mag2005@med.cornell.edu

Current HIV/AIDS Reports
|August 11, 2005
PubMed

Insights

HIV patients on antiretroviral therapy face increased coronary heart disease risk. Modifiable factors like dyslipidemia and inflammation contribute, necessitating risk assessment and intervention for long-term cardiovascular health.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection is associated with long-term coronary heart disease (CHD) risk.
  • HIV-infected individuals may experience accelerated atherosclerosis due to factors including HIV itself, ART, dyslipidemia, insulin resistance, diabetes mellitus, and lipodystrophy.
  • Chronic inflammation and prothrombotic states are implicated in the pathogenesis of CHD within the HIV-positive population.

Purpose of the Study:

  • To highlight the increased risk of coronary heart disease (CHD) in patients with human immunodeficiency virus (HIV) undergoing antiretroviral therapy (ART).
  • To identify modifiable risk factors contributing to cardiovascular complications in HIV-infected patients.
  • To emphasize the need for clinical assessment and management of CHD risk factors in this population.

Main Methods:

  • Review of epidemiological studies examining the association between highly active antiretroviral therapy (HAART) and myocardial infarction (MI) risk.
  • Analysis of contributing factors to cardiovascular disease in HIV-infected patients, including metabolic changes and inflammatory markers.
  • Synthesis of current understanding regarding the pathogenesis of CHD in the context of HIV infection and its treatment.

Main Results:

  • Epidemiological data indicate an elevated relative risk of myocardial infarction (MI) in HIV-infected patients receiving highly active antiretroviral therapy (HAART).
  • While short-term absolute risk may be low, cumulative risk of cardiovascular events increases over time.
  • Metabolic changes associated with lipodystrophy and chronic inflammation contribute significantly to atherosclerosis in HIV patients.

Conclusions:

  • Clinicians should proactively assess coronary heart disease (CHD) risk in all human immunodeficiency virus (HIV)-infected patients.
  • Intervention strategies targeting modifiable risk factors are crucial for mitigating long-term cardiovascular risk in HIV-positive individuals on antiretroviral therapy (ART).
  • Long-term management of HIV requires a comprehensive approach to cardiovascular health, addressing both disease-specific and traditional risk factors.

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