What happens to cardiovascular system behind the undetectable level of HIV viremia?

Gabriella d'Ettorre1, Giancarlo Ceccarelli1, Paolo Pavone1

  • 1Department of Public Health and Infectious Diseases, University of Rome "Sapienza", Viale del Policlinico 155, Rome, Italy.

Insights

Despite improvements in HIV treatment, cardiovascular diseases remain a significant concern for infected individuals. This review explores new insights into managing non-AIDS-related heart conditions in patients with suppressed HIV.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Combined antiretroviral therapy (cART) has improved HIV patient longevity and quality of life.
  • HIV-infected individuals still face reduced survival rates compared to the general population, largely due to non-infectious illnesses like cardiovascular diseases.
  • Studies show an elevated risk of coronary atherosclerotic disease and myocardial infarction in HIV patients on cART.

Purpose of the Study:

  • To review current understanding and new insights into non-AIDS-related cardiovascular diseases in HIV patients with suppressed viral load.
  • To address the challenges in managing cardiovascular comorbidities in the context of HIV infection.

Main Methods:

  • This is a review article, synthesizing existing research and literature.
  • Focuses on factors contributing to cardiovascular disease pathogenesis in HIV patients.
  • Examines clinical management strategies for cardiovascular issues in this population.

Main Results:

  • Multiple factors contribute to cardiovascular problems in HIV patients, including lifestyle, metabolic parameters, genetics, viral factors, immune activation, chronic inflammation, and cART side effects.
  • These factors complicate the clinical management of cardiovascular diseases in HIV-infected individuals.
  • Non-infectious illnesses, particularly cardiovascular diseases, represent an emerging challenge for physicians treating HIV patients.

Conclusions:

  • Cardiovascular disease management in HIV patients with suppressed viremia requires a comprehensive approach.
  • Understanding the multifactorial pathogenesis is crucial for effective treatment.
  • Further research and clinical strategies are needed to mitigate cardiovascular risks in the HIV-infected population.

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