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Cardiovascular Complications of HIV in Endemic Countries

  • Public Health Policy (T Gaziano, Section Editor)
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Abstract

Effective combination antiretroviral therapy (ART) has enabled human immunodeficiency virus (HIV) infection to evolve from a generally fatal condition to a manageable chronic disease. This transition began two decades ago in high-income countries and has more recently begun in lower income, HIV endemic countries (HIV-ECs). With this transition, there has been a concurrent shift in clinical and public health burden from AIDS-related complications and opportunistic infections to those associated with well-controlled HIV disease, including cardiovascular disease (CVD). In the current treatment era, traditional CVD risk factors and HIV-related factors both contribute to an elevated risk of myocardial infarction, stroke, heart failure, and arrhythmias. In HIV-ECs, the high prevalence of persons living with HIV and growing prevalence of CVD risk factors will contribute to a growing epidemic of HIV-associated CVD. In this review, we discuss the epidemiology and pathophysiology of cardiovascular complications of HIV and the resultant implications for public health efforts in HIV-ECs.

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Acknowledgments

Christopher T. Longenecker reports grants from NIH (K23 HL123341). Matthew J. Feinstein reports grants from the American Heart Association (16 FTF 31200010)

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Authors and Affiliations

  1. Division of Cardiovascular Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL, USA

    Matthew J. Feinstein

  2. Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Milana Bogorodskaya & Christopher T. Longenecker

  3. Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA

    Milana Bogorodskaya

  4. Division of Cardiology, Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, NC, USA

    Gerald S. Bloomfield

  5. Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Rajesh Vedanthan

  6. Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Mark J. Siedner

  7. Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA

    Gene F. Kwan

  8. Division of Cardiology, Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA

    Christopher T. Longenecker

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  1. Matthew J. Feinstein
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Correspondence to Matthew J. Feinstein.

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Conflict of Interest

Christopher T. Longenecker reports personal fees from Gilead Sciences, grants from Bristol Myers-Squibb, and grants from Medtronic Philanthropy.

Matthew J. Feinstein, Milana Bogorodskaya, Gerald S. Bloomfield, Rajesh Vedanthan, Mark J. Siedner, and Gene F. Kwan declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Feinstein, M.J., Bogorodskaya, M., Bloomfield, G.S. et al. Cardiovascular Complications of HIV in Endemic Countries. Curr Cardiol Rep 18, 113 (2016). https://doi.org/10.1007/s11886-016-0794-x

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