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Atherosclerosis and Cardiovascular Complications in People Living with HIV: A Focused Review.
Infect Dis Rep
September 2024
Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, 95123 Catania, Italy.
The intersection of Human Immunodeficiency Virus (HIV) infection and cardiovascular disease (CVD) represents a significant area of concern; advancements in antiretroviral therapy (ART) have notably extended the life expectancy of people living with HIV (PLWH), concurrently elevating the prevalence of chronic conditions such as CVD. This paper explores the multifaceted relationship between HIV infection, ART, and cardiovascular health, focusing on the mechanisms by which HIV and ART contribute to increased cardiovascular risk, including the promotion of endothelial dysfunction, inflammation, immune activation, and metabolic disturbances. We highlight the critical roles of HIV-associated proteins-Tat, Nef, and gp120-in accelerating atherosclerosis through direct and indirect pathways that exacerbate endothelial damage and inflammation.
View Article and Find Full Text PDFPrevention and treatment of cardiovascular disease in HIV: practical insights in an evolving field.
Top Antivir Med
December 2023
Northwestern University Feinsberg School of Medicine, Chicago, Illinois, USA.
People with HIV (PWH) are at higher risk for cardiovascular disease (CVD) than people without HIV. As antiretroviral therapy (ART) and the natural history of HIV have evolved, so have the pathogenesis and manifestations of HIV-associated CVD. Epidemiologic data from several cohorts demonstrate that PWH have an approximately 50% higher risk than people without HIV for CVD, including, but not limited to, myocardial infarction and heart failure.
View Article and Find Full Text PDFPharmacological and Behavioral Interventions to Mitigate Premature Aging in Patients with HIV.
Curr HIV/AIDS Rep
December 2023
Section of Infectious Disease, Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA.
Purpose Of Review: We sought to review pharmacological and behavioral interventions that have been publicly presented, published, or are currently ongoing to prevent or mitigate the effect of premature HIV-associated comorbidities.
Recent Findings: Multiple studies have been conducted in hopes of finding an effective intervention. While the choice of antiretroviral regimen influences recovery of immune function, several drugs used as adjunct treatments have proven effective to mitigate premature aging.
An open label randomized controlled trial of atorvastatin versus aspirin in elite controllers and antiretroviral-treated people with HIV.
AIDS
October 2023
Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda.
Background: Residual inflammation in people with HIV (PWH) despite suppression of HIV replication is associated with many comorbidities including cardiovascular disease. Targeting inflammation may decrease the risk of cardiovascular disease.
Methods: An open label randomized study was conducted to evaluate the effect of nine months of 81 mg aspirin versus 40 mg atorvastatin in antiretroviral therapy (ART) treated PWH and elite controllers (EC), not on ART.
Statin protects men but not women with HIV against loss of muscle mass, strength, and physical function: a pilot study.
Sci Rep
March 2023
Health Sciences Graduate Studies, State University of Londrina, Londrina, Paraná, Brazil.
Statins are cholesterol-lowering drugs commonly used among people with HIV, associated with an increased risk of myopathies. Considering that cardiovascular disease, statin therapy, and sarcopenia are independently prevalent in people with HIV, clarity on the potential benefits or harms of statin therapy on muscle health is useful to provide insight into ways to maximize skeletal muscle health and minimize CVD risk in this population. We aimed to study the effects of statin therapy on strength, muscle mass, and physical function parameters in people with HIV.
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