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HIV and cardiovascular disease

Kaku So-Armah1, Laura A Benjamin2, Gerald S Bloomfield3

  • 1Boston University School of Medicine, Boston, MA, USA.

The Lancet. HIV
|April 4, 2020
PubMed

Insights

Cardiovascular disease risk factors in people with HIV vary globally, particularly between sub-Saharan Africa and Western countries. Tailored risk reduction strategies are crucial for effective HIV and cardiovascular disease care worldwide.

Area of Science:

  • Global Health
  • Cardiology
  • Infectious Diseases

Background:

  • HIV research on cardiovascular disease (CVD) is concentrated in Europe and North America.
  • Sub-Saharan Africa bears the largest burden of HIV, with 25.6 million people living with the virus.
  • Geographical variations in CVD risk factors necessitate localized approaches to HIV-related CVD management.

Purpose of the Study:

  • To highlight the differing profiles of cardiovascular disease risk factors in people with HIV across diverse geographical regions.
  • To advocate for tailored strategies in HIV-related CVD risk reduction, considering global disparities.
  • To inform future research priorities for integrated HIV and CVD care.

Main Methods:

  • Comparative analysis of cardiovascular disease risk factor distribution based on geographical location (sub-Saharan Africa vs. Europe/North America).
  • Review of traditional and non-traditional CVD risk factors in the context of HIV.
  • Synthesis of current research gaps and future research directions.

Main Results:

  • Sub-Saharan Africa presents a unique CVD risk profile in people with HIV, characterized by younger populations, higher hypertension rates, lower smoking, and lower cholesterol compared to Western regions.
  • These demographic and epidemiological differences result in distinct CVD profiles between low-income and high-income countries.
  • Existing research predominantly overlooks the specific needs and risk profiles of populations in low-income settings.

Conclusions:

  • HIV-related CVD risk reduction strategies must be geographically tailored, accounting for local risk factor distributions.
  • Integration of CVD risk reduction into HIV care guidelines is essential, considering both traditional and non-traditional risk factors like antiretroviral therapy side effects and indoor air pollution.
  • Future research should focus on implementation science for integrated care models, CVD in women with HIV, and tobacco cessation.

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