title: Endothelial and platelet function alterations in HIV-infected patients.
abstract: The HIV epidemic has huge dimensions: in 2009, 33.3million people worldwide, including 2.5million children, were affected by human immunodeficiency virus (HIV) infection. The introduction of Highly Active Anti-Retroviral Therapy (HAART) has significantly modified the course of HIV disease, with longer survival and improved quality of life, but it has simultaneously lead to the appearance of previously unrecognized complications, such as ischemic cardiovascular events. Many studies have shown a higher rate of premature atherosclerosis in patients with HIV infection, leading to coronary, cerebrovascular, or peripheral arterial disease. However, it is still debated whether cardiovascular complications are a consequence of HIV infection itself or of the long-term use of HAART. In particular, myocardial infarction has been suggested to be associated with the use of abacavir. Endothelial dysfunction and platelet activation are markers of atherosclerosis and of increased cardiovascular risk. Here we review the evidence that endothelial dysfunction and platelet alterations are associated with chronic HIV infection, the possible role of different HAARTs, and the possible pathophysiologic mechanisms. Potential therapeutic implications are also discussed.
authors.affiliation: Division of Internal and Cardiovascular Medicine, Department of Internal Medicine, University of Perugia, Perugia, Italy. grespa@unipg.it
authors.forename: P
authors.initials: P
authors.lastname: Gresele
authors.forename: E
authors.initials: E
authors.lastname: Falcinelli
authors.forename: M
authors.initials: M
authors.lastname: Sebastiano
authors.forename: F
authors.initials: F
authors.lastname: Baldelli
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism* / Q000821:virology; D002318:Cardiovascular Diseases / Q000097:blood / Q000139:chemically induced / Q000209:etiology* / Q000821:virology; D042783:Endothelial Cells / Q000187:drug effects / Q000378:metabolism* / Q000821:virology; D006678:HIV / Q000472:pathogenicity; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors