title: Accelerated cardiovascular disease and myocardial infarction risk in patients with the human immunodeficiency virus.
abstract: Highly active antiretroviral therapy has greatly reduced mortality among human immunodeficiency virus (HIV)-infected patients by delaying, and possibly preventing, progression to AIDS. The risk of cardiovascular disease (CVD) is now an important consideration in these patients and may increase as they live longer. Risk factors for CVD, the inflammatory effects of HIV, and the metabolic complications of antiretroviral therapy may accelerate the onset of CVD. Death from myocardial infarction, however, is still rare compared with death from progression of HIV disease, and the benefits of antiretroviral therapy clearly outweigh any associated risk of CVD. In this review, the authors describe the risk of accelerated CVD in HIV-infected individuals, the proposed viral and therapy-related mechanisms of CVD, the clinical features of CVD in these patients, and monitoring and management guidelines to reduce CVD risk. Identifying, monitoring, and treating CVD risk factors in HIV-positive patients is vital to improving their lives and should become standard practice.
authors.affiliation: University of Miami Miller School of Medicine, Miami, FL 33101, USA.
authors.forename: Tanvi S
authors.initials: TS
authors.lastname: Sharma
authors.forename: Sarah
authors.initials: S
authors.lastname: Messiah
authors.forename: Stacy
authors.initials: S
authors.lastname: Fisher
authors.forename: Tracie L
authors.initials: TL
authors.lastname: Miller
authors.forename: Steven E
authors.initials: SE
authors.lastname: Lipshultz
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D018450:Disease Progression; D006678:HIV; D015658:HIV Infections / Q000150:complications*; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*