Cardiovascular Disease in HIV Patients: A Comprehensive Review of Current Knowledge and Clinical Implications

Area of Science:

• Cardiology
• Infectious Diseases
• Immunology

Background:

• Improved life expectancy in human immune deficiency (HIV) patients has shifted focus to long-term cardiovascular health impacts.
• While infectious and AIDS-related complications have decreased due to highly active antiretroviral therapies (HAART), chronic inflammation and autoimmunity remain significant concerns.

Purpose of the Study:

• To review the current literature on the prevalence, diagnosis, and unique characteristics of cardiovascular disease (CVD) in HIV patients.
• To examine the role of protease inhibitors (PIs) and complementary therapies in HIV-associated CVD.
• To understand the shift towards more chronic cardiovascular manifestations in the era of HAART.

Main Methods:

• Literature review of current research on cardiovascular disease in HIV patients.
• Analysis of studies focusing on prevalence, diagnosis, and unique CVD characteristics.
• Inclusion of data on patients treated with protease inhibitors and complementary therapies.

Main Results:

• Advancements in HAART have reduced infectious pathologies but persistent chronic inflammation and autoimmunity contribute to increased CVD risk.
• Elevated inflammatory markers (high-sensitivity C-reactive protein, cytokines) are common, promoting endothelial dysfunction, coagulation disorders, and accelerated atherogenesis.
• HIV patients now exhibit more chronic and insidious cardiovascular manifestations.

Conclusions:

• Despite improved prognoses, cardiovascular disease remains a critical concern for HIV patients, characterized by chronic inflammation and accelerated atherogenesis.
• The clinical presentation of CVD in HIV has evolved, necessitating ongoing monitoring and management strategies tailored to these chronic manifestations.