Cerebrovascular diseases in HIV-infected patients.
Cerebrovascular disease (CVD) has early been recognized in HIV-infected patients, including infectious arteritis, inflammatory vasculitis, aneurismal and small-vessel arteriopathy, to which adds now the premature atherosclerotic cerebral arteriopathy associated with the highly active antiretroviral therapy (HAART)-induced metabolic disorders. As a result of the increased life-expectancy associated with HAART, HIV patients grow older and are exposed to the combined vascular risk of antiviral-induced metabolic changes and advancing age. Several studies have documented subclinical cervical artery atherosclerosis, as assessed by intima-media thickness, ultrasound detection of carotid artery plaques and intracerebral small-vessel disease, all being associated with the induced metabolic changes. This suggests that vascular prevention should be performed on a long-term basis.
Monsuez
Jean-Jacques
JJ
AP-HP, Hôpital René Muret, Cardiologie, Policlinique Médicale, Université Paris-13, Faculté de Médecine de Bobigny, SEVRAN 93270, France. jean-jacques.monsuez@rmb.aphp.fr
Goujon
Colette
C
Wyplosz
Benjamin
B
Couzigou
Carine
C
Escaut
Lelia
L
Vittecoq
Daniel
D
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000378:metabolism / Q000473:pathology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans