HIV infection and atherosclerosis: evaluating the drivers of inflammation

Area of Science:

• Immunology
• Cardiology
• Infectious Diseases

Background:

• Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of death in the aging HIV-positive population.
• Traditional cardiovascular risk factors are prevalent in people with HIV.
• Certain antiretroviral therapies (ART) can exacerbate metabolic conditions like hyperlipidemia and insulin resistance.

Purpose of the Study:

• To summarize the current understanding of immune activation and inflammation drivers in people with HIV.
• To elucidate the contribution of these inflammatory processes to ASCVD in this population.

Main Methods:

• Review of current literature on HIV, inflammation, and ASCVD.
• Analysis of mechanisms driving immune activation in HIV infection.
• Examination of the role of co-infections and bacterial translocation in inflammation.

Main Results:

• HIV infection inherently promotes immune activation and chronic inflammation.
• Co-infections (Hepatitis C, Cytomegalovirus) and HIV itself contribute to inflammation.
• Bacterial product translocation across a compromised gut barrier is another key inflammatory pathway.

Conclusions:

• Inflammation is a critical, underappreciated factor in HIV-associated ASCVD.
• Understanding these drivers is essential for developing targeted ASCVD prevention strategies in people with HIV.