Evolving mechanisms and presentations of cardiovascular disease in people with HIV: implications for management.
Ilana NazariMatthew J FeinsteinPublished in: Clinical microbiology reviews (2024)
SUMMARYPeople with HIV (PWH) are at elevated risk for cardiovascular diseases (CVDs), including myocardial infarction, heart failure, and sudden cardiac death, among other CVD manifestations. Chronic immune dysregulation resulting in persistent inflammation is common among PWH, particularly those with sustained viremia and impaired CD4+ T cell recovery. This inflammatory milieu is a major contributor to CVDs among PWH, in concert with common comorbidities (such as dyslipidemia and smoking) and, to a lesser extent, off-target effects of antiretroviral therapy. In this review, we discuss the clinical and mechanistic evidence surrounding heightened CVD risks among PWH, implications for specific CVD manifestations, and practical guidance for management in the setting of evolving data.
Keyphrases
- antiretroviral therapy
- cardiovascular disease
- hiv infected
- hiv positive
- human immunodeficiency virus
- heart failure
- hiv aids
- hiv infected patients
- oxidative stress
- hepatitis c virus
- men who have sex with men
- hiv testing
- left ventricular
- type diabetes
- electronic health record
- smoking cessation
- cardiovascular risk factors
- machine learning
- risk assessment
- acute heart failure
- climate change