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Published on: October 12, 2017
HIV-related cardiovascular disease: any role for high-density lipoproteins?
Peter Hudson1, Nicholas J Woudberg1, Festus Kamau2
1Department of Medicine, Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa.
Insights
Antiretroviral therapy (ART) improves HIV survival but increases cardiovascular disease (CVD) risk. Research suggests changes in high-density lipoprotein (HDL) may be an early biomarker for this risk.
Area of Science:
- Cardiology
- Infectious Diseases
- Biochemistry
Background:
- Antiretroviral therapy (ART) has significantly improved human immunodeficiency virus (HIV) patient longevity.
- HIV-infected individuals face a higher risk of noncommunicable diseases, particularly atherosclerotic cardiovascular disease (CVD).
- The interplay between ART, HIV infection, and CVD pathophysiology requires further elucidation.
Purpose of the Study:
- To review potential early biomarkers for cardiovascular risk in the HIV population.
- To explore the role of high-density lipoprotein (HDL) alterations in HIV-associated CVD.
Main Methods:
- Literature review focusing on recent data regarding HDL structure and function in HIV and ART.
- Analysis of potential mechanisms linking HIV and ART to cardiovascular pathophysiology.
Main Results:
- Recent data indicate that both HIV infection and ART may induce structural modifications in HDL.
- These modifications can lead to alterations in HDL subclass distribution and impaired HDL functionality.
Conclusions:
- Alterations in HDL, including changes in its structure, subclass, and function, are postulated as potential early biomarkers for cardiovascular risk in HIV patients.
- Understanding these HDL changes is critical for managing CVD risk in this population.
Abstract:
The introduction of antiretroviral therapy (ART) has improved the life expectancy of patients infected with human immunodeficiency virus (HIV). However, this population is at an increased risk for noncommunicable diseases, including atherosclerotic cardiovascular disease (CVD). Both ART and viral infection may be potential contributors to the pathophysiology of HIV-related CVD. The mechanisms behind this remain unclear, but it is critical to delineate early biomarkers of cardiovascular risk in the HIV population. In this review, we postulate that potential biomarkers could include alterations to high-density lipoprotein (HDL). Indeed, recent data suggest that HIV and ART may induce structural changes of HDL, thus resulting in shifts in HDL subclass distribution and HDL functionality.
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