HIV-specific immune dysregulation and atherosclerosis.
HIV + patients face a heightened risk of cardiovascular disease (CVD), which cannot be fully explained by traditional risk factors or antiretroviral therapy (ART)-related cardiotoxicity. Increasing evidence suggests a significant contribution of HIV-specific immune dysregulation to atherosclerosis. HIV-specific immune dysregulation may have the following atherogenic effects: 1) activation of endothelial and immune cells; 2) enhancement of the percentage of circulating atherogenic immune cell subsets; and 3) modification of lipid function. Efforts are underway to link immune dysregulation markers with validated CVD endpoints and to identify genetic predispositions for HIV-induced atherogenesis. Moreover, immune suppressants are under evaluation in HIV + patients to attempt modification of immune-mediated CVD risk. Taken together, these studies will enhance understanding of CVD risk stratification and reduction strategies in HIV.
Endocrine Division, Program in Nutritional Metabolism, Massachusetts General Hospital, 55 Fruit St 5LON 207, Boston, MA 02114, USA. mzanni@partners.org
Markella V
MV
Zanni
Steven K
SK
Grinspoon
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000235:genetics / Q000276:immunology*; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D050197:Atherosclerosis / Q000209:etiology / Q000235:genetics / Q000276:immunology* / Q000821:virology*; D049109:Cell Proliferation; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008055:Lipids / Q000276:immunology*; D008213:Lymphocyte Activation / Q000276:immunology*; D008297:Male; D012307:Risk Factors
D019380:Anti-HIV Agents; D008055:Lipids