Sudden cardiac death in HIV-infected patients: A contemporary review

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• HIV-infected individuals exhibit an elevated risk of sudden cardiac death (SCD) compared to the general population.
• The precise mechanisms driving this increased SCD risk in HIV patients are not fully understood.
• This heightened risk is likely multifactorial, necessitating a comprehensive review of contributing factors.

Purpose of the Study:

• To review and summarize the potential mechanisms contributing to sudden cardiac death in the HIV-infected patient population.
• To elucidate the complex interplay of factors leading to increased SCD risk in HIV.
• To identify areas for future research and potential interventions.

Main Methods:

• A comprehensive literature review was conducted.
• Studies investigating cardiac complications and mortality in HIV-infected individuals were analyzed.
• Potential mechanisms contributing to sudden cardiac death were identified and synthesized.

Main Results:

• Biologic plausibility suggests several mechanisms contribute to increased SCD risk in HIV patients.
• These include ventricular arrhythmias, myocardial fibrosis/scar, and prolonged QTc interval.
• Other contributing factors identified are substance abuse, structural heart disease, and premature atherosclerosis.

Conclusions:

• Further understanding of SCD mechanisms in HIV is essential for identifying modifiable risk factors.
• This knowledge can inform public health programs and potentially revise implantable cardioverter-defibrillator (ICD) guidelines.
• Additional research is required to determine the relative contribution of each identified mechanism and risk factor to SCD in HIV-infected individuals.