Left ventricular dysfunction in human immunodeficiency virus infection

Area of Science:

• Cardiology
• Infectious Diseases
• Pharmacology

Background:

• The link between human immunodeficiency virus (HIV) infection and cardiovascular disease, particularly myocardial infarction, is under investigation.
• While increased myocardial infarction risk is noted in HIV patients on highly active antiretroviral therapy (HAART), the impact on left ventricular function is less studied.
• Subclinical left ventricular dysfunction is common in HIV-infected individuals, irrespective of viral control, indicating potential early-stage cardiac complications.

Purpose of the Study:

• To review existing evidence on left ventricular dysfunction associated with HIV infection and HAART.
• To explore the potential direct and indirect mechanisms by which HIV and HAART may affect myocardial function.

Main Methods:

• Literature review of studies over the past 20 years.
• Analysis of evidence from both Westernized and developing countries.
• Synthesis of data on left ventricular function in HIV-infected populations.

Main Results:

• Subclinical left ventricular dysfunction is a prevalent finding in HIV-infected individuals.
• Both HIV infection and HAART are implicated, though their specific roles and independent contributions remain unclear.
• Potential contributing factors include chronic inflammation, metabolic complications (insulin resistance, lipotoxicity, dyslipidemia), and mitochondrial toxicity.

Conclusions:

• HIV infection and HAART are associated with an increased risk of left ventricular dysfunction.
• Further research is needed to elucidate the precise mechanisms and clinical implications.
• Early detection and management of cardiac dysfunction in HIV patients are crucial.