title: HIV Infection and Primary Prevention of Cardiovascular Disease: Lights and Shadows in the HAART Era.
abstract: With the progressive increase in life-expectancy of human immunodeficiency virus (HIV)-positive patients in the "highly active antiretroviral therapy" (HAART) era, co-morbidities, particularly cardiovascular (CV) diseases (CVD) are emerging as an important concern. The pathophysiology of CVD in this population is complex, due to the interaction of classical CV risk factors, viral infection and the effects of antiretroviral therapy (ARV). The role of ARV drugs in HIV is double edged. While these drugs reduce systemic inflammation, an important factor in CV development, they may at the same time be proatherogenic by inducing dyslipidemia, body fat redistribution and insulin resistance. In these patients primary prevention is challenging, considering the lower median age at which acute coronary syndromes occur. Furthermore prevention is still limited by the lack of robust evidence-based, HIV-specific recommendations. Therefore we performed a comprehensive evaluation of the literature to analyze current knowledge on CVD prevalence in HIV-infected patients, traditional and HIV-specific risk factors and risk stratification, and to summarize the recommendations for primary prevention of CVD in this HIV population.
authors.affiliation: Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Ballocca
authors.affiliation: Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Gili
authors.affiliation: Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Turin, Italy. Electronic address: fabrizio.dascenzo@gmail.com.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.affiliation: Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Walter Grosso
authors.initials: WG
authors.lastname: Marra
authors.affiliation: Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Cannillo
authors.affiliation: Division of Infectious Disease, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Calcagno
authors.affiliation: Division of Infectious Disease, Amedeo di Savoia Hospital, Turin, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonora
authors.affiliation: University Heart Center, University Hospital Zurich, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Flammer
authors.affiliation: Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York.
authors.forename: John
authors.initials: J
authors.lastname: Coppola
authors.affiliation: Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
authors.affiliation: Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D011322:Primary Prevention / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents
keywords: Cardiovascular disease; HAART; HIV; Human immunodeficiency virus; Primary prevention