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Atherosclerosis and HIV: Exploring Cardiovascular Risks and Management
Matthew Seplowe1, Anjali Goyal2, Tolison Fowler3
1From the Department of Hospital Medicine, Mount Sinai Morningside, New York, NY.
Insights
People with HIV face higher risks of atherosclerotic cardiovascular disease (ASCVD). This review explores HIV
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Antiretroviral therapy has increased HIV survival, shifting focus to chronic conditions like atherosclerotic cardiovascular disease (ASCVD).
- People with HIV exhibit increased incidence of myocardial infarction, stroke, and heart failure compared to the general population.
- HIV infection and its treatment interact with traditional cardiovascular risk factors, elevating ASCVD risk.
Purpose of the Study:
- To review the epidemiology, pathophysiology, and management of ASCVD in people living with HIV.
- To explore the complex relationship between HIV, antiretroviral therapy, and cardiovascular health.
- To synthesize current research to inform clinical practice and improve cardiovascular outcomes in this population.
Main Methods:
- Literature review synthesizing data from clinical trials.
- Analysis of observational studies on HIV and ASCVD.
- Inclusion of basic research on HIV-associated cardiovascular pathophysiology.
Main Results:
- Emerging evidence confirms an elevated risk of ASCVD in people living with HIV.
- Specific cardiovascular events like heart attack, stroke, and heart failure are more common.
- The interplay of HIV, treatment, and risk factors contributes to this increased ASCVD burden.
Conclusions:
- Comprehensive cardiovascular risk reduction strategies are essential for people with HIV.
- Enhanced understanding of HIV-associated ASCVD is crucial for improving patient longevity and quality of life.
- Tailored healthcare approaches are needed to manage ASCVD in the context of HIV infection.
Abstract:
The advent of antiretroviral therapy has markedly improved the life expectancy of individuals with HIV, leading to a shift in clinical focus from managing opportunistic infections to addressing chronic conditions, such as atherosclerotic cardiovascular disease (ASCVD). Emerging evidence highlights an elevated risk of ASCVD among people living with HIV, characterized by a higher incidence of acute myocardial infarction, ischemic stroke, and heart failure compared with the general population. This review examines the epidemiology, pathophysiology, and management of ASCVD in the context of HIV. It explores the interplay between HIV infection, antiretroviral therapy, and traditional cardiovascular risk factors, underscoring the need for comprehensive cardiovascular risk reduction strategies tailored to people living with HIV. Through synthesizing data from clinical trials, observational studies, and basic research, the review aims to enhance understanding of HIV-associated ASCVD and inform healthcare practices to improve the longevity and quality of life for this patient population.
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