HIV Management Guide for Clinical Care and ARV Guidelines

HIV Management Guide for Clinical Care and ARV Guidelines

Heart disease

Heart disease in HIV infection

Anthony Dart Alfred Hospital and Baker Medical Research Institute, Melbourne. Last reviewed: November 2019 Introduction The arrival of effective antiretroviral therapy (ART) has meant that there are many HIV-infected people living to advanced age. Therefore, diseases more associated with the middle and older years will achieve increasing importance as co-morbidities of HIV infection. In the …

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Pulmonary hypertension

Pulmonary arterial hypertension (PAH) in the setting of HIV infection recently acquired its own specific category in the Updated Classification of Pulmonary Hypertension (1). It consistently has been found in 0.5% of HIV-infected people, a figure unchanged by the widespread use of effective ART (2) and represents a rate about a thousand times greater than …

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Cardiac malignancy

Malignant conditions of the heart are rare but have been seen in HIV-infected patients, particularly in those with more advanced immunodeficiency. Non-Hodgkin’s lymphoma and Kaposi’s sarcoma have both been reported to affect the heart. The impact of ART has been reported to be most profound on KS of the heart, reducing the prevalence from up …

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Infective endocarditis

HIV infection is not seen as a particular risk factor for infective endocarditis (IE), however it can occur and, in a similar way to the HIV-uninfected population, it is more frequently seen in those people who inject drugs. The advent of ART does not seem to have had a large impact on prevalence of IE …

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Cardiac arrythmias

In a large US study of more than 30,000 veterans, 2.6% developed atrial fibrillation (AF) over a median time of 6.8 years. This was significantly more common (and independent of other risk factors) in those with lower CD4+ T cell counts and higher HIV viral loads (17). As in all cases of AF, treatment is …

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References

Galiè N, Humbert M, Vachiery JL et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and        Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and           the European Respiratory Society (ERS): Endorsed by: Association for European      Paediatric …

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