Cardiovascular Complications of HIV in Endemic Countries

Curr Cardiol Rep. 2016 Nov;18(11):113. doi: 10.1007/s11886-016-0794-x.

Abstract

Effective combination antiretroviral therapy (ART) has enabled human immunodeficiency virus (HIV) infection to evolve from a generally fatal condition to a manageable chronic disease. This transition began two decades ago in high-income countries and has more recently begun in lower income, HIV endemic countries (HIV-ECs). With this transition, there has been a concurrent shift in clinical and public health burden from AIDS-related complications and opportunistic infections to those associated with well-controlled HIV disease, including cardiovascular disease (CVD). In the current treatment era, traditional CVD risk factors and HIV-related factors both contribute to an elevated risk of myocardial infarction, stroke, heart failure, and arrhythmias. In HIV-ECs, the high prevalence of persons living with HIV and growing prevalence of CVD risk factors will contribute to a growing epidemic of HIV-associated CVD. In this review, we discuss the epidemiology and pathophysiology of cardiovascular complications of HIV and the resultant implications for public health efforts in HIV-ECs.

Keywords: Cardiovascular epidemiology; Global health; HIV; Health disparities; Human immunodeficiency virus; Risk factors.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / complications
  • AIDS-Related Opportunistic Infections / physiopathology
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use*
  • Cardiomyopathies / virology
  • Drug Therapy, Combination
  • HIV Infections / complications*
  • HIV Infections / physiopathology
  • HIV Infections / virology
  • Heart Failure / etiology*
  • Heart Failure / physiopathology
  • Heart Failure / virology
  • Humans
  • Myocardial Infarction / etiology*
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / virology
  • Prevalence
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / physiopathology
  • Stroke / etiology*
  • Stroke / physiopathology
  • Stroke / virology

Substances

  • Anti-HIV Agents