Thrombotic and cardiovascular events in HIV infection (Review)

Area of Science:

• Cardiovascular Science
• Infectious Diseases
• Hematology

Background:

• Human Immunodeficiency Virus (HIV) infection has transitioned into a chronic disease due to antiretroviral therapy (ART).
• While ART improves longevity and quality of life, it contributes to new complications, notably thromboembolic events.
• HIV-associated chronic inflammation, endothelial dysfunction, and ART-induced metabolic changes create a prothrombotic state.

Purpose of the Study:

• To review the multifactorial mechanisms underlying the increased thrombotic risk in HIV-infected individuals.
• To highlight the heightened risk of venous thromboembolism and cardiovascular disease in the HIV population.
• To discuss specific ART-related risks, other coagulation disorders, and therapeutic considerations in HIV patients.

Main Methods:

• Literature review of studies on HIV, thromboembolism, and cardiovascular disease.
• Analysis of pathophysiological mechanisms including inflammation, endothelial dysfunction, and ART effects.
• Examination of co-infection and gut microbiome influences on the prothrombotic microenvironment.

Main Results:

• Individuals with HIV face a significantly higher risk of venous thromboembolism and cardiovascular disease compared to the general population.
• Certain ART regimens are associated with an increased risk of myocardial infarction in HIV patients.
• HIV infection is linked to other coagulation disorders like heparin-induced thrombocytopenia and thrombotic thrombocytopenic purpura.

Conclusions:

• HIV infection and its management, particularly ART, contribute to a prothrombotic state and increased cardiovascular risk.
• Careful consideration of drug interactions is necessary when managing coagulation disorders in HIV patients.
• Further research is essential to elucidate underlying mechanisms and develop targeted treatments for thrombotic complications in HIV.