HIV and Coronary Heart Disease

Cardiovascular disease, and particularly coronary heart disease, is an emerging area of concern in the HIV population. Since the advent of efficient antiretroviral therapies and the consequent longer patient life span, an increased risk for myocardial infarction has been observed in HIV-infected pat...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2013-02, Vol.61 (5), p.511-523
Main Authors: Boccara, Franck, MD, PhD, Lang, Sylvie, PhD, Meuleman, Catherine, MD, Ederhy, Stephane, MD, Mary-Krause, Murielle, PhD, Costagliola, Dominique, PhD, Capeau, Jacqueline, MD, PhD, Cohen, Ariel, MD, PhD
Format: Article
Language:English
Subjects:
Antiretroviral drugs
atherosclerosis
Cardiology
Cardiovascular
Cardiovascular disease
chronic inflammation
coronary heart disease
Coronary vessels
Drug therapy
HIV
Human immunodeficiency virus
immune activation
Internal Medicine
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Summary:Cardiovascular disease, and particularly coronary heart disease, is an emerging area of concern in the HIV population. Since the advent of efficient antiretroviral therapies and the consequent longer patient life span, an increased risk for myocardial infarction has been observed in HIV-infected patients compared with the general population in Western countries. The pathophysiology of this accelerated atherosclerotic process is complex and multifactorial. Traditional cardiovascular risk factors—overrepresented in the HIV population—associated with uncontrolled viral replication and exposure to antiretroviral drugs (per se or through lipid and glucose disturbances) could promote acute ischemic events. Thus, despite successful antiviral therapy, numerous studies suggest a role of chronic inflammation, together with immune activation, that could lead to vascular dysfunction and atherothrombosis. It is time for physicians to prevent coronary heart disease in this high-risk population through the use of tools employed in the general population. Moreover, the lower median age at which acute coronary syndromes occur in HIV-infected patients should shift prevention to include patients
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2012.06.063