Epidemiology of ischemic heart disease in HIV

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Cardiovascular disease (CVD) is increasingly impacting morbidity and mortality in individuals with HIV, surpassing AIDS-related diagnoses.
• HIV infection confers a 1.5 to two-fold increased risk of ischemic heart disease (IHD), influenced by sex and disease status.

Purpose of the Study:

• To synthesize recent data on the risk of ischemic heart disease (IHD) in individuals with HIV.
• To highlight the evolving landscape of CVD risk in the context of HIV infection.

Main Methods:

• Literature review and synthesis of recent studies on IHD risk in HIV-infected populations.
• Analysis of identified risk factors, including traditional CVD factors and HIV-specific elements like inflammation and immune activation.

Main Results:

• HIV-associated IHD risk is significant, with variations based on sex and virologic/immunologic status.
• Both traditional CVD risk factors and HIV-specific factors (inflammation, immune activation) contribute to increased risk.
• While some antiretroviral therapies (ART) may pose CVD risks, viral suppression through ART generally benefits CVD risk.
• Current CVD prevention strategies for the general population are insufficient for HIV-infected individuals.

Conclusions:

• Elevated IHD risk presents a major clinical and public health challenge for the growing population of individuals with HIV.
• Developing and implementing HIV-specific interventions for CVD risk management is crucial for improving long-term health outcomes.
• Tailored CVD risk prediction algorithms and interventions are under active investigation to mitigate risks in this population.