Human immunodeficiency virus & cardiovascular risk

Abstract

Highly active antiretroviral therapy (HAART) significantly changed the prevalence of the cardiovascular manifestations of human immunodeficiency virus (HIV)/AIDS. In developed countries, a 30 per cent reduction in the prevalence of cardiomyopathy and pericardial effusion was observed, possibly related to a reduction of opportunistic infections and myocarditis. In developing countries, however, where the availablity of HAART is limited, and the pathogenic impact of nutritional factors is significant, a 32 per cent increase was seen in the prevalence of cardiomyopathy and related high mortality rate from congestive heart failure. Also, some HAART regimens in developed countries, especially those including protease inhibitors, may cause, in a high proportion of HIV-infected patients, a lipodystrophy syndrome that is associated with an increased risk of cardiovascular events related to a process of accelerated atherosclerosis. Careful cardiac screening is warranted for patients who are being evaluated for, or who are receiving HAART regimens, particularly for those with known underlying cardiovascular risk factors, according to the most recent clinical guidelines.

Qualidade de vida de pacientes idosos vivendo com HIV/AIDS

“…As características clínicas, epidemiológicas e comorbidades dos pacientes encontradas nesta pesquisa estão alinhadas com as de outros estudos: tempo de diagnóstico tardio 35,36 , via sexual como forma mais prevalente de contaminação 34 , predomínio da contagem de linfócitos T CD4+ na faixa ≥ 350 células/mm 3 no mês da entrevista 18 e doenças cardiovasculares como mais frequentes 37 .…”

Human Immunodeficiency Virus Infection–Related Heart Disease

“…19 This decrease has been attributed to a commensurate decline in opportunistic infections and myocarditis. 19 However, the prevalence in countries without access to HAART remains high. The numbers have actually increased by 32% because of scant resources and additional nutritional deficiencies attributable to malnutrition and diarrhea (eg, selenium and vitamin B 12 ).…”

“…17,18 DCM was thought to be associated with an inflammatory response to the virus leading directly to right and left ventricular dysfunction. 19 With the introduction of HAART, the prevalence of cardiomyopathy has decreased by 30% in developed countries. 19 This decrease has been attributed to a commensurate decline in opportunistic infections and myocarditis.…”

“…19 With the introduction of HAART, the prevalence of cardiomyopathy has decreased by 30% in developed countries. 19 This decrease has been attributed to a commensurate decline in opportunistic infections and myocarditis. 19 However, the prevalence in countries without access to HAART remains high.…”

Cardiac involvement in HIV-positive patients

“…7 On the other hand, in developing countries the median prevalence of HIV-associated cardiomyopathy has increased with about 32%, in conjunction with a limited availability of HAART. 8 An increase in the life expectancy of HIVpositive patients associated a shift in the spectrum of health problems, with emphasis on non-infectious comorbidities, lifestyle-related and ageing issues, such as: arterial hypertension, metabolic changes (hyperglycemia, hyperlipidemia), 9 accelerated atherosclerosis, including but not limited to coronary artery disease. 10 The history of HIV/AIDS in Romania is different compared to the rest of the world, 11 due to the epidemic that occurred in the end of the '80s, when a large number of patients were infected with clade F HIV, 12 mostly children and infants.…”