Guidelines

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 …

Atherosclerotic vascular disease in people with HIV infection Read More »

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 …

Pathogenesis of cardiovascular disease in people with HIV infection Read More »

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 …

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

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, …

Impact of co-infections on cardiovascular disease risk Read More »

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 …

Coronary artery disease outcomes Read More »

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 …

References Read More »