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Pathogenesis of cardiovascular disease in HIV infection

Andrew Carr1

  • 1St Vincent's Hospital and University of New South Wales, Sydney, Australia. acarr@stvincents.com.au

Current Opinion in HIV and AIDS
|April 18, 2009
PubMed

Insights

Effective antiretroviral therapy that suppresses HIV without metabolic side effects is key to reducing cardiovascular disease (CVD) risk in adults. Understanding HIV

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Cardiovascular disease (CVD) is a leading cause of mortality in adults with HIV infection.
  • Understanding the mechanisms of CVD in HIV is crucial for effective management strategies.

Purpose of the Study:

  • To review the pathogenesis of cardiovascular disease in HIV-infected adults.
  • To identify factors contributing to CVD risk in the context of HIV infection and its treatment.

Main Methods:

  • Review of current literature on HIV, antiretroviral therapy (ART), and cardiovascular disease.
  • Analysis of the metabolic and direct effects of HIV and ART on cardiovascular health.

Main Results:

  • Certain antiretroviral therapies, particularly older protease inhibitors and thymidine analogues, are linked to dyslipidemia and insulin resistance.
  • While current protease inhibitors have modest adverse glycemic effects, about half of ART-associated CVD risk remains unexplained by lipid abnormalities.
  • Untreated HIV infection is associated with increased pro-inflammatory markers (D-dimer) and potential direct vascular effects.

Conclusions:

  • Antiretroviral therapy that effectively suppresses HIV with minimal metabolic impact is associated with the lowest CVD risk.
  • Further research is needed to fully elucidate the direct effects of HIV on vascular tissue and their clinical significance.
Abstract

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