title: Coronary Artery Disease in HIV-Infected Patients: Downside of Living Longer.
abstract: OBJECTIVE
  Introduction of combination antiretroviral therapy (ART) has increased the life expectancy of patients with HIV infection, allowing them to live longer with this chronic medical condition and consequently experiencing conditions such as cardiovascular diseases (CVDs). Several studies have investigated the increased risk of CVD in people living with HIV (PLWH). However, less is known about the exact mechanisms involved in this increased risk. Also, specific guidelines for management of CVD in PLWH have not been developed yet. In this article, we review the recent literature on the mechanisms involved in pathogenesis of CVD in PLWH, with an emphasis on coronary artery disease (CAD).
  
  
  RESULTS
  Although initial studies suspected the increased prevalence of traditional CVD risk factors and side effects of ART to be involved in the increased CVD risk in PLWH, recent studies have uncovered the important role of chronic persistent inflammation in this increased risk. In addition, biomarkers of inflammation have been associated with both CVD events and subclinical CAD in this population. Lastly, recent studies and ongoing clinical trials have been investigating medical interventions that aim to reduce inflammation and cardiovascular events. Different mechanisms of inflammation have been examined in PLWH, including subclinical viremia, microbial translocation, and coinfection with other pathogens such as cytomegalovirus. Although inflammatory biomarkers have been consistently associated with CVD and subclinical CVD outcomes, their prognostic value is unknown. Recent and ongoing trials are exploring the benefits of anti-inflammatory drugs, statins, and antimicrobial translocation drugs on both inflammation and CVD risk among PLWH.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: John Charles A
authors.initials: JC
authors.lastname: Lacson
authors.affiliation: Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Revery P
authors.initials: RP
authors.lastname: Barnes
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. hbahrami@med.usc.edu.|Division of Cardiovascular Medicine, Department of Medicine, University of Southern California, Los Angeles, CA, USA. hbahrami@med.usc.edu.|Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. hbahrami@med.usc.edu.|Division of Cardiology, Department of Medicine, Keck School of Medicine of University of Southern California, 2020 Zonal Ave, Los Angeles, CA, 90033, USA. hbahrami@med.usc.edu.
authors.forename: Hossein
authors.initials: H
authors.lastname: Bahrami
mesh_terms: D015415:Biomarkers / Q000032:analysis; D060085:Coinfection; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007249:Inflammation; D015995:Prevalence; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: Biomarkers; Cardiovascular disease; Clinical trials; Coronary artery disease; HIV infection; Inflammation