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Published on: December 16, 2019
Cardiovascular Complications of HIV-Associated Immune Dysfunction
Akram M Zaaqoq1, Faisal A Khasawneh2, Roger D Smalligan3
1Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA ; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA.
Insights
People with HIV experience more cardiovascular diseases (CVD) due to immune dysfunction and inflammation. Early antiretroviral therapy and managing traditional risk factors are key for better outcomes.
Area of Science:
- Infectious Diseases
- Cardiology
- Immunology
Background:
- Prolonged survival in HIV infection leads to increased non-HIV-related comorbidities.
- Cardiovascular diseases (CVD) occur earlier and at higher rates in HIV-positive individuals compared to HIV-negative individuals.
Purpose of the Study:
- To explore the contributing factors to increased cardiovascular disease risk in HIV-infected patients.
- To highlight the role of immune dysfunction and inflammation as nontraditional risk factors for CVD in HIV.
Main Methods:
- Review of proposed traditional and nontraditional risk factors for CVD in HIV.
- Examination of elevated inflammatory markers (e.g., hs-CRP, D-dimer, IL-6) and their association with CVD risk.
Main Results:
- Immune dysfunction is a significant nontraditional risk factor for cardiovascular pathology in HIV.
- Elevated inflammatory markers are associated with increased CVD risk in HIV-infected patients.
Conclusions:
- Early initiation of antiretroviral therapy (ART) is recommended.
- Aggressive management of traditional CVD risk factors is crucial for HIV-positive individuals.
- Further research into CVD mechanisms and chronic inflammation modification in HIV is needed.
Abstract:
Prolonged survival in HIV infection is accompanied by an increased frequency of non-HIV-related comorbidities. It is suggested that cardiovascular diseases (CVD) occur earlier among HIV-positive patients compared with HIV-negative patients, and at a higher rate. Several factors have been proposed which can be categorized into traditional and nontraditional risk factors. Immune dysfunction is a nontraditional risk factor that contributes significantly to cardiovascular pathology. Markers of inflammation are elevated in HIV-infected patients, and elevations in markers such as high-sensitivity C-reactive protein, D-dimer, and interleukin-6 (IL-6) have been associated with increased risk for cardiovascular disease. However, the data currently suggest the most practical advice is to start antiretroviral therapy early and to manage traditional risk factors for CVD aggressively. A better understanding of the mechanisms of CVD in this population and further efforts to modify chronic inflammation remain an important research area.
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