Prevention of cardiovascular disease among people living with HIV in sub-Saharan Africa

Prog Cardiovasc Dis. 2020 Mar-Apr;63(2):149-159. doi: 10.1016/j.pcad.2020.02.004. Epub 2020 Feb 5.


As longevity has increased for people living with HIV (PLWH) in the United States and Europe, there has been a concomitant increase in the prevalence of cardiovascular disease (CVD) risk factors and morbidity in this population. Whereas the availability of HIV antiretroviral therapy has resulted in dramatic increases in life expectancy in sub-Saharan Africa (SSA), where over two thirds of PLWH reside, if and how these trends impact the epidemiology of CVD is less clear. In this review, we describe the current state of the science on how both HIV and its treatment impact CVD risk factors and outcomes among PLWH in sub-Saharan Africa, including regional factors (unique to SSA) likely to differentiate these relationships from the global North. We then outline how current regional guidelines address CVD prevention among PLWH and which clinical and structural interventions are best poised to confront the co-epidemics of HIV and CVD in the region. We conclude with a discussion of key research gaps that need to be addressed to optimally develop an actionable public health response.

Keywords: Cardiovascular disease; Cardiovascular risk factors; People living with HIV; Sub-Saharan Africa.

Publication types

  • Research Support, N.I.H., Extramural
  • Systematic Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control*
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Long-Term Survivors*
  • Health Status
  • Health Status Disparities
  • Healthcare Disparities
  • Humans
  • Life Expectancy
  • Preventive Health Services*
  • Prognosis
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Viral Load


  • Anti-HIV Agents