Cardiovascular risk factors and HIV disease

An increased rate of coronary heart diseases is becoming an important cause of morbidity and mortality among HIV-infected patients. This emerging problem is due to the antiretroviral therapy success that allows HIV-positive patients to live longer. Increased coronary heart disease rates in the HIV population, as in the noninfected population, may be related to traditional risk factors, including advancing age, higher smoking rates, dyslipidemia, insulin resistance, and impaired glucose tolerance. Some nontraditional factors have to be considered too: these are due to the direct effects of the virus on the vasculature, as well as to direct effects of specific antiretroviral drugs, including inflammation, endothelial dysfunction, metabolic disorders, prothrombotic state, and changes in body composition with loss of subcutaneous fat and/or accumulation of visceral fat. The aim of this paper is to review traditional and emerging cardiovascular risk factors and consider their possible interactions in HIV-infected patients.