Ischemic Heart Disease in HIV: An In-depth Look at Cardiovascular Risk

Area of Science:

• Cardiology
• Infectious Diseases
• Pharmacology

Background:

• Cardiovascular diseases (CVDs) are a significant concern in human immunodeficiency virus (HIV)-infected patients, despite reduced incidence with antiretroviral therapy (ART).
• HIV-associated cardiovascular risk, especially ischemic heart disease (IHD), is higher than in the general population due to complex interactions.
• Increased life expectancy and chronic HIV infection have made CVD a leading cause of morbidity and mortality in this population.

Purpose of the Study:

• To review the current understanding of cardiovascular risk in HIV-infected patients.
• To discuss the management of ischemic heart disease and acute coronary syndrome in the context of HIV infection.
• To provide guidance on safe cardiovascular treatments considering drug interactions with ART.

Main Methods:

• This is a review article, synthesizing existing literature on HIV and cardiovascular disease.
• It discusses patient-dependent, virus-dependent, and antiretroviral therapy-associated factors influencing cardiovascular risk.
• The review focuses on clinical manifestations, particularly ischemic heart disease and acute coronary syndrome.

Main Results:

• Cardiovascular risk, especially ischemic heart disease, is higher in HIV-infected individuals compared to uninfected individuals.
• Antiretroviral therapy, while crucial for HIV management, introduces pharmacokinetic interactions that affect cardiovascular treatment choices.
• Ischemic heart disease is the most common cardiovascular manifestation in developed countries among HIV patients.

Conclusions:

• Cardiovascular disease is a critical issue in the long-term management of HIV infection.
• Primary prevention strategies are essential to mitigate cardiovascular risk in HIV patients.
• Clinical cardiologists require specific knowledge to safely manage cardiovascular conditions in HIV-infected patients.