title: Accelerated coronary atherosclerosis after execution of percutaneous coronary intervention in patient with HIV/HCV coinfection: case report and review of the literature.
abstract: Highly active antiretroviral therapy has greatly reduced AIDS-related morbidity and mortality; however, its widespread use has been associated with a marked rise in the frequency of cardiovascular diseases in patients with HIV. Moreover, HIV infection is associated with accelerated coronary atherosclerosis and vasculopathy, although the mechanisms underlying these findings have not been determined. We describe the case of a 45-year-old woman with HIV/HCV coinfection, irritable bowel syndrome, and accelerated progression of coronary atherosclerosis after execution of percutaneous coronary intervention (PCI). In this case, the rapidity of progression of atherosclerosis seems linked principally to chronic inflammation and excess immune activation that can depend by a concourse of factors (chronic C hepatitis, irritable bowel syndrome, PCI execution) not directly associated with traditional risk factors. Caregivers following HIV-infected patients should be aware of the increased risk of accelerated atherogenesis in these subjects, principally in case of presence of causes of intense immune activation.
authors.affiliation: Department of Infectious Diseases and Public Health, University of Rome Sapienza, Italy. giancarlo.ceccarelli@uniroma1.it
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ceccarelli
authors.forename: Gabriella
authors.initials: G
authors.lastname: d'Ettorre
authors.forename: Massimo
authors.initials: M
authors.lastname: Mancone
authors.forename: Marco
authors.initials: M
authors.lastname: Francone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Vullo
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D060085:Coinfection; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000628:therapy; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications; D008875:Middle Aged; D036542:Tomography, Spiral Computed / Q000379:methods