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Published on: October 6, 2016
Are we successfully managing cardiovascular disease in people living with HIV?
Camilla I Hatleberg1, Jens D Lundgren, Lene Ryom
1CHIP (Centre of Excellence for Health, Immunity and Infections), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Insights
Cardiovascular disease (CVD) management in people living with HIV (PLWHIV) requires improved screening and prevention strategies. Current approaches are suboptimal, necessitating further research, especially for HIV-positive women.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Cardiovascular disease (CVD) is a significant concern for people living with HIV (PLWHIV).
- The etiology of CVD in PLWHIV is complex and multifactorial.
- Current CVD risk factor management in PLWHIV is suboptimal.
Purpose of the Study:
- To review recent research on CVD management in PLWHIV.
- To focus on screening, primary, and secondary prevention strategies.
- To highlight the need for improved CVD risk factor management.
Main Methods:
- Literature review of recent studies.
- Analysis of current screening and prevention guidelines.
- Identification of gaps in research and clinical practice.
Main Results:
- Data on CVD screening and prevention in PLWHIV are scarce.
- Optimal risk screening tools for early/subclinical disease are lacking.
- PLWHIV are undertreated with preventive medications (statins, aspirin, antihypertensives).
- Effective lifestyle intervention programs (smoking cessation, physical activity, diet) are absent.
- HIV-positive women represent a particularly vulnerable subgroup requiring focused attention.
Conclusions:
- Further research is needed to identify barriers to optimal CVD risk factor management in PLWHIV.
- Increased focus on CVD prevention strategies for HIV-positive women is crucial.
- Multifaceted approaches are essential for effective CVD management in PLWHIV.
Purpose Of Review:
The aim of this study was to discuss the most recent research in the management of cardiovascular disease (CVD) in people living with HIV (PLWHIV) with a focus on screening, primary and secondary prevention.
Recent Findings:
The cause of CVD in PLWHIV is complex and multifactorial and creates a demand for a multifaceted approach to screening and prevention. Current screening and management of CVD risk factors in PLWHIV is suboptimal, reasons for this are not clear and the data are still scarce both in the primary and secondary preventive setting. There are no optimal routine risk screening tools available to accurately detect early and subclinical disease; PLWHIV are undertreated with preventive drugs such as statins and aspirin and antihypertensives; there are still no programmes that have been shown significantly efficient over time with regards to improved smoking cessation, increased physical activity and optimal diet, and recent reports call for intensified focus on HIV-positive women as a particularly vulnerable subgroup.
Summary:
There is a need for further studies investigating barriers to optimal CVD risk factor management in PLWHIV and an increased focus of CVD prevention in HIV-positive women.
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