HAART to heart: highly active antiretroviral therapy and the risk of cardiovascular disease in HIV-infected or exposed children and adults.
Infection with HIV is independently associated with an increased risk for clinical heart failure, cardiomyopathies and premature atherosclerosis, including stroke and myocardial infarction in both the pre-HAART and HAART eras. HAART is also associated with clinical cardiovascular concerns. In HIV-infected individuals, HAART may cause adverse lipid profiles and increased risk for cardiovascular events. Its effects on the developing heart remain unclear. Although in utero HAART exposure may improve cardiac function in the first 2 years of life, it may also inhibit myocardial growth. Additional potentially damaging cardiovascular effects of HAART are present, and continuing cardiovascular risk evaluations, screening and follow-up of treated patients is necessary. Here, we review available research in this field and highlight the importance of understanding known complications and their mechanisms.
Department of Pediatrics (D820), University of Miami Miller School of Medicine, PO Box 16820, Miami, FL 33101, USA. slipshultz@med.miami.edu
Steven E
SE
Lipshultz
Catherine M
CM
Mas
Jacqueline M
JM
Henkel
Vivian I
VI
Franco
Stacy D
SD
Fisher
Tracie L
TL
Miller
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000150:complications / Q000209:etiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012306:Risk; D012307:Risk Factors