title: Cardiovascular Complications of HIV in Endemic Countries.
abstract: Effective combination antiretroviral therapy (ART) has enabled human immunodeficiency virus (HIV) infection to evolve from a generally fatal condition to a manageable chronic disease. This transition began two decades ago in high-income countries and has more recently begun in lower income, HIV endemic countries (HIV-ECs). With this transition, there has been a concurrent shift in clinical and public health burden from AIDS-related complications and opportunistic infections to those associated with well-controlled HIV disease, including cardiovascular disease (CVD). In the current treatment era, traditional CVD risk factors and HIV-related factors both contribute to an elevated risk of myocardial infarction, stroke, heart failure, and arrhythmias. In HIV-ECs, the high prevalence of persons living with HIV and growing prevalence of CVD risk factors will contribute to a growing epidemic of HIV-associated CVD. In this review, we discuss the epidemiology and pathophysiology of cardiovascular complications of HIV and the resultant implications for public health efforts in HIV-ECs.
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL, USA. Matthewjfeinstein@northwestern.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Feinstein
authors.affiliation: Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.|Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Milana
authors.initials: M
authors.lastname: Bogorodskaya
authors.affiliation: Division of Cardiology, Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, NC, USA.
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Bloomfield
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Vedanthan
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Siedner
authors.affiliation: Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Gene F
authors.initials: GF
authors.lastname: Kwan
authors.affiliation: Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.|Division of Cardiology, Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Longenecker
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000503:physiopathology; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000821:virology; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology / Q000821:virology; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology / Q000821:virology; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000503:physiopathology; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology / Q000821:virology
chemical_list: D019380:Anti-HIV Agents
keywords: Cardiovascular epidemiology; Global health; HIV; Health disparities; Human immunodeficiency virus; Risk factors