HIV and Cardiovascular Disease Burden in Young Adults (18-25 years): A Review of Current Evidence

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Young people living with HIV (PLWH) face a growing burden of cardiovascular disease (CVD).
• Traditional risk factors for CVD may not fully explain the pathology in this population.
• Understanding HIV-associated CVD mechanisms in youth is critical for effective management.

Purpose of the Study:

• To synthesize current evidence on the cardiovascular disease burden in young people living with HIV.
• To explore myocardial and vascular pathology in HIV-associated CVD among youth.
• To evaluate advanced imaging techniques and identify knowledge gaps in HIV-associated CVD mechanisms.

Main Methods:

• Systematic review of current scientific literature.
• Analysis of myocardial and vascular pathology in youth with HIV.
• Evaluation of advanced imaging modalities for detecting subclinical CVD.

Main Results:

• HIV-associated CVD in youth appears driven by non-atherosclerotic mechanisms like myocardial injury and fibrosis.
• Subclinical myocardial changes, including increased left ventricular mass and reduced strain, are observed via imaging.
• Longitudinal data and multimodal imaging are scarce, especially in African settings.

Conclusions:

• The current understanding of HIV-associated CVD in youth may be incomplete, with atherosclerosis not being the sole driver.
• There is a critical need for longitudinal, mechanistic research, particularly in high-burden regions.
• Developing tailored clinical strategies and policy interventions is essential to reduce long-term cardiovascular morbidity in young PLWH.