Update on cardiovascular complications in HIV infection

HIV-infected patients are at increased risk of cardiovascular disease (CVD), reflecting interaction of risk associated with host, virus, and antiretroviral therapy factors. Although traditional risk factors appear to increase risk to a similar degree in HIV-infected and HIV-uninfected persons, some risk factors (eg, smoking) may be more common in HIV-infected persons. HIV infection per se may further increase CVD risk via proatherosclerotic effects on smooth muscle cells and macrophages or by increasing inflammation. Some drugs in the protease inhibitor class are associated with increased risk, at least partly in association with adverse lipid effects. The magnitude and mechanisms of risk reported to be associated with recent use of abacavir remain undefined. This article summarizes a presentation on cardiovascular complications in HIV infection made by Judith S. Currier, MD, at an International AIDS Society-USA continuing medical education course in Los Angeles in February 2009. The original presentation is available as a Webcast at www.iasusa.org.