State of the Science Conference

Grinspoon, Steven; Grünfeld, Carl; Kotler, Donald P.; Currier, Judith S.; Lundgren, Jens D.; Dubé, Michael P.; Lipshultz, Steven E.; Hsue, Priscilla Y.; Squires, Kathleen; Schambelan, Morris; Wilson, Peter W.F.; Yarasheski, Kevin E.; Hadigan, Colleen; Stein, James H.; Eckel, Robert H.

doi:10.1161/circulationaha.107.189622

Cited by 192 publications

(49 citation statements)

References 71 publications

(51 reference statements)

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“…The greater cardiovascular risk and incidence of cardiovascular events in HIV-infected patients is explained by a greater prevalence of CVRF in this population, together with the inflammatory effect of HIV itself and the metabolic alterations associated with antiretroviral therapy [1][2][3][4][5][6][7][8][9][10]. ABC has always been considered one of the more benign antiretroviral drugs, with a better metabolic profile than other nucleoside analogues [3,8,11,17,22,23].…”

Section: Discussionmentioning

confidence: 99%

“…A greater prevalence of cardiovascular risk factors (CVRF) has been seen in patients infected with HIV than in the general population [1,2], with the resulting increase in cardiovascular risk [3][4][5] and incidence of cardiovascular events [6][7][8]. Both the HIV infection itself as well as the antiretroviral therapy (ART) seem to play a role in the development of cardiovascular events in these persons [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…Both the HIV infection itself as well as the antiretroviral therapy (ART) seem to play a role in the development of cardiovascular events in these persons [9,10]. Although protease inhibitors and thymidine analogues have so far been the drugs most involved in metabolic alterations and cardiovascular disease in HIV-infected patients [4][5][6][7][8], a relation has also been reported between the use of abacavir (ABC) and an increased risk of acute myocardial infarction of up to 90% [11]. Notwithstanding this, controversy still exists about the association between ABC and ischaemic heart disease [8,9,[12][13][14][15][16][17], and little is known about the pathogenic mechanism by which ABC induces a greater risk of coronary heart disease.…”

Section: Introductionmentioning

confidence: 99%

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Whole blood platelet aggregometry in HIV-infected patients on treatment with abacavir

Muñoz¹,

Correa²,

Ruiz³

et al. 2012

OJIM

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Whole blood platelet aggregometry in HIV-infected patients on treatment with abacavir

Muñoz¹,

Correa²,

Ruiz³

et al. 2012

OJIM

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“…For these reasons, treatment of HIV may be considered part of a strategy to reduce stroke risk, among other benefits. Current guidelines for the management of patients with HIV, therefore, include the presence of a high risk of vascular disease as a reason to initiate HAART, even among patients with CD4 counts >350/mm 3 [45]. This guideline represents, in fact, one of the few official recommendations to use antiretroviral therapies to reduce the risk of vascular disease [53].…”

Section: Implications For Prevention Of Stroke In Hiv-infected Patientsmentioning

confidence: 99%

Recent Developments regarding Human Immunodeficiency Virus Infection and Stroke

2012

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Human immunodeficiency virus (HIV) infection is strongly associated with ischemic stroke in the young. Data obtained from the Nationwide Inpatient Sample in the United States show an increase in the number of stroke hospitalizations in the HIV-infected population despite an overall decrease in the number of stroke hospitalizations. Few data exist, however, that address the mechanism of HIV-associated stroke. Recent studies have demonstrated that HIV may infect the endothelium and alter cerebrovascular functions. Whether the proposed mechanism alters the stroke risk is undetermined. Epidemiological studies suggest that HIV-related stroke is associated with a risk factor profile that differs from the HIV-negative young stroke population in that HIV-associated strokes are less likely to have hypertension, diabetes, hyperlipidemia and smoking as risk factors. A large population-based study, moreover, suggests an association between antiretroviral therapy and increased cardio- and cerebrovascular risks. Specific antiretroviral agents such as protease inhibitors and non-nucleoside reverse transcriptase inhibitors have been implicated in the metabolic syndrome, accelerated atherosclerosis and an increased risk for ischemic stroke. In addition to discussing these developments, this paper also discusses the implications of recent data for stroke prevention in HIV-infected patients.

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“…1–3 The pathogenesis of atherosclerotic vascular disease that culminates in morbid events begins with well-described mechanisms that include inflammation, endothelial dysfunction, plaque formation and thrombogenesis. Factors that amplify atherogenesis in HIV-infected persons include a greater prevalence of traditional risk factors (e.g., smoking, dyslipidemia), direct consequences of HIV infection itself, and exposure to specific antiretroviral drugs.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers and HIV-associated cardiovascular disease

Baker

Duprez

2010

Current Opinion in HIV and AIDS

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Purpose of Review Our goal is to summarize recent literature on biomarkers of cardiovascular disease (CVD) in the setting of HIV infection with an emphasis on those associated with clinical events. Recent Findings Epidemiological data have demonstrated that HIV-infection is associated with increases in well-established markers of inflammation and thrombosis, and levels of hsCRP, IL-6, D-dimer and fibrinogen predict CVD and mortality risk in HIV cohorts. Levels of IL-6, D-dimer and endothelial adhesion molecules increase when antiretroviral therapy is interrupted, suggesting HIV replication may be driving CVD risk in this context. However, data on changes in many CVD biomarkers after starting ART are inconsistent or lacking. Finally, assessment of high-density lipoprotein particle concentration may provide important information specific to HIV-related CVD risk beyond that apparent from traditional measures of serum cholesterol. Summary Biomarkers of inflammation and thrombosis have the potential to improve CVD risk stratification beyond traditional and HIV-specific factors, and may prove useful for evaluating CVD prevention strategies for individuals with HIV infection.

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State of the Science Conference

Cited by 192 publications

References 71 publications

Whole blood platelet aggregometry in HIV-infected patients on treatment with abacavir

Whole blood platelet aggregometry in HIV-infected patients on treatment with abacavir

Recent Developments regarding Human Immunodeficiency Virus Infection and Stroke

Biomarkers and HIV-associated cardiovascular disease

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