title: Pathophysiology and management of cardiovascular disease in patients with HIV.
abstract: Results from several studies have suggested that people with HIV have an increased risk of cardiovascular disease, especially coronary heart disease, compared with people not infected with HIV. People living with HIV have an increased prevalence of traditional cardiovascular disease risk factors, and HIV-specific mechanisms such as immune activation. Although older, more metabolically harmful antiretroviral regimens probably contributed to the risk of cardiovascular disease, new data suggest that early and continuous use of modern regimens, which might have fewer metabolic effects, minimises the risk of myocardial infarction by maintaining viral suppression and decreasing immune activation. Even with antiretroviral therapy, however, immune activation persists in people with HIV and could contribute to accelerated atherosclerosis, especially of coronary lesions that are susceptible to rupture. Therefore, treatments that safely reduce inflammation in people with HIV could provide additional cardiovascular protection alongside treatment of both traditional and non-traditional risk factors.
authors.affiliation: Program in Nutritional Metabolism, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Nou
authors.affiliation: Program in Nutritional Metabolism, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Lo
authors.affiliation: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: Hadigan
authors.affiliation: Program in Nutritional Metabolism, Massachusetts General Hospital, Boston, MA, USA. Electronic address: sgrinspoon@mgh.harvard.edu.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Grinspoon
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003327:Coronary Disease / Q000276:immunology* / Q000517:prevention & control / Q000821:virology; D019468:Disease Management; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D012307:Risk Factors
chemical_list: D044966:Anti-Retroviral Agents