Occlusive Arterial Disease in HIV-infected Patients: a Preliminary Report

Nair, R.; Robbs, J V; Chetty, Runjan; Naidoo, N G; Woolgar, Justin

doi:10.1053/ejvs.2000.1195

Cited by 24 publications

(11 citation statements)

References 16 publications

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“…Gisselbrecht et al identified 8 cases of vasculitis among 450 HIV-infected patients, among which 5 met the classification criteria of polyarteritis nodosa [23]. Vasculitis associated with arterial thrombosis has been reported by Nair in 20 young patients from South Africa [26]. A clinicopathologic evaluation has been performed by Gherardi et al who found 34 inflammatory vascular diseases among muscle, nerve or skin biopsy specimens from 148 HIVinfected patients.…”

Section: Inflammatory Vasculitismentioning

confidence: 99%

HIV-associated vascular diseases: Structural and functional changes, clinical implications

Monsuez

Charniot

Escaut

et al. 2009

International Journal of Cardiology

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Section: Inflammatory Vasculitismentioning

confidence: 99%

HIV-associated vascular diseases: Structural and functional changes, clinical implications

Monsuez

Charniot

Escaut

et al. 2009

International Journal of Cardiology

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“…41,42 These abnormalities have been associated with documented thromboses involving both veins and arteries and seem to be related to PIcontaining HAART. 41,43,44 Thrombocytosis has been reported in 9% of patients receiving HAART, with cardiovascular complications in up to 25% of the cases. 45 According to the Pavia Consensus Statement, the routine evaluation of coagulation parameters is probably not advisable until the benefit of widespread screening is assessed in prospective studies.…”

Section: Haart and Coagulation Disordersmentioning

confidence: 99%

Highly Active Antiretroviral Therapy–Associated Metabolic Syndrome: Pathogenesis and Cardiovascular Risk*

Bárbaro

2006

American Journal of Therapeutics

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The introduction of highly active antiretroviral therapy (HAART) has significantly modified the course of HIV disease, with longer survival and improved quality of life of HIV-infected subjects. However, HAART regimens, especially those including protease inhibitors (PIs) have been shown to cause in a high proportion of HIV-infected patients a metabolic syndrome that may be associated with an increased risk of cardiovascular disease (about 1.4 cardiac events per 1,000 years of therapy according to the Framingham score). Metabolic features associated with somatic changes (lipodystrophy/lipoatrophy) include dyslipidemia (about 70% of patients), insulin resistance (elevated C-peptide and insulin), type 2 diabetes mellitus (8%-10% of the patients), hypertension (up to 75% of patients), coagulation abnormalities (25% of patients), lactic acidemia, and elevated hepatic transaminases (nonalcoholic steatohepatitis). HAART-associated metabolic syndrome is an increasingly recognized clinical entity. A better understanding of the molecular mechanisms responsible for this syndrome will lead to the discovery of new drugs that will reduce the cardiovascular risk in patients under HAART. A careful stratification of the cardiovascular risk and cardiovascular monitoring of patients under HAART is needed according to the most recent clinical guidelines.

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“…HAART-induced insulin resistance may cause increased sympathetic activity and sodium retention, potentially leading to hypertension [42,43]. Recent reports indicate that elevated blood pressure may be related to PI-induced lipodystrophy and metabolic disorders, especially to fasting triglyceride levels [44].…”

Section: Haart Hypertension and Coagulative Disordersmentioning

confidence: 99%

“…Moreover, HIV-infected patients, especially those with fat redistribution, may develop coagulation abnormalities such as increased levels of fibrinogen, D-dimer, plasminogen activator inhibitor-1 and tissue-type plasminogen activator antigen, or deficiency of protein S [45,46]. These abnormalities have been associated with documented thromboses involving both veins and arteries and seem to be related to PI-containing HAART [43,45]. In a large multicentre epidemiologic survey, Sullivan et al reported an incidence of clinically recognized thrombosis of 2.6/1000 person/year in a sample of 42,935 HIV-infected adults.…”

Section: Haart Hypertension and Coagulative Disordersmentioning

confidence: 99%

HIV Infection, Antiretroviral Therapy and Cardiovascular Risk

Bárbaro

2002

European Journal of Cardiovascular Prevention & Rehabilitat

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Vascular complications in the course of human immunodeficiency virus (HIV) infection are multifactorial and may be caused by the virus itself or by the related opportunistic infections and neoplasms. Highly active antiretroviral therapy (HAART), which dramatically modifies the natural history of HIV disease, causes in a high proportion of patients a metabolic syndrome that includes body fat redistribution, hypercholesterolaemia, hypertriglyceridaemia and insulin resistance. These effects are particularly evident in patients treated with protease inhibitors (PIs). However, studies on the cardiovascular risk among HIV-infected individuals receiving PIs have not shown a consistent association. The pathogenesis of the HAART-associated metabolic syndrome has not been completely elucidated, but there is growing evidence that a synergistic effect between PIs and nucleoside reverse transcriptase inhibitors might play a significant role. All HIV-infected patients candidate to antiretroviral therapy and patients already under treatment should undergo an assessment that includes the evaluation of the cardiovascular risk with the available guidelines.

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Occlusive Arterial Disease in HIV-infected Patients: a Preliminary Report

Abstract: initial experience with large-vessel occlusive disease in HIV positive patients suggests an underlying arteritic aetiology, with clinical and pathological features distinct from atherosclerosis. Further in-depth study is necessary to clarify the pathophysiological basis thereof.

Cited by 24 publications

References 16 publications

HIV-associated vascular diseases: Structural and functional changes, clinical implications

HIV-associated vascular diseases: Structural and functional changes, clinical implications

Highly Active Antiretroviral Therapy–Associated Metabolic Syndrome: Pathogenesis and Cardiovascular Risk*

HIV Infection, Antiretroviral Therapy and Cardiovascular Risk

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