HIV Management Guide for Clinical Care and ARV Guidelines

HIV Management Guide for Clinical Care and ARV Guidelines

Atherosclerotic vascular disease

Atherosclerotic vascular disease in people with HIV infection

Janine Trevyllian1, David Nolan2  Department of Infectious Diseases, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC Department of Clinical Immunology, Royal Perth Hospital, Perth, WA Last reviewed: October 2019 Introduction While antiretroviral therapy (ART) has led to dramatic improvements in life expectancy for people with HIV infection [1], there is evidence that …

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Pathogenesis of cardiovascular disease in people with HIV infection

HIV-associated CVD is the result of complex interactions between traditional cardiovascular risk factors, side effects of ART and the chronic inflammation and immune activation associated with long term HIV infection. It is important to acknowledge, however, that the assessment and management of traditional CVD risk factors according to standard guidelines is still the cornerstone of …

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Inflammation and immune activation as a cause of atherosclerosis in HIV infection

Atherosclerosis is primarily a disease of inflammation. When the lining of the arterial wall (the endothelium) becomes inflamed, lipid laden foam cells are promoted and drive progression from asymptomatic fatty streaks to pathological atherosclerotic plaques. Foam cells are generated when activated monocytes ingest cholesterol, take up residence in the endothelial wall and then secrete inflammatory …

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Impact of co-infections on cardiovascular disease risk

Co-infections with other viral or bacterial pathogens may increase CVD risk by enhancing HIV-associated immune activation and inflammation or through direct effects on the vascular endothelium. The best studied of these pathogens is cytomegalovirus (CMV), which can activate endothelial cells, promote inflammation and has been associated with serious non-AIDS events, including CVD [52]. As yet, …

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Coronary artery disease outcomes

As discussed above, people with HIV infection experience coronary artery disease at approximately 1.5 times the rates seen in the general population. While initially thought to occur not only at higher rates but also prematurely [55], recent analyses have shown that coronary artery disease occurs at similar ages in people with HIV infection and the …

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References

Samji H, Cescon A, Hogg RS, Modur SP, Althoff KN, Buchacz K, et al. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One 2013; 8(12):e81355. Smith C, Sabin CA, Lundgren JD, Thiebaut R, Weber R, Law M, et al. Factors associated with specific causes of …

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