Register      Login
Microbiology Australia Microbiology Australia Society
Microbiology Australia, bringing Microbiologists together
RESEARCH ARTICLE

Protecting the heart after HAART; understanding the pathogenesis of cardiovascular disease in people living with HIV

Janine M Trevillyan A and Jennifer F Hoy A B
+ Author Affiliations
- Author Affiliations

A Department of Infectious Diseases
Alfred Hospital and Monash University
Commercial Road
Melbourne, Vic. 3000, Australia

B Department of Infectious Diseases
Alfred Hospital and Monash University
Commercial Road
Melbourne, Vic. 3000, Australia
Tel: +61 3 9076 6900
Fax: +61 3 90762431
Email: jennifer.hoy@monash.edu

Microbiology Australia 35(2) 91-93 https://doi.org/10.1071/MA14027
Published: 28 April 2014

Abstract

Advances in the management of HIV and antiretroviral therapy (ART) have led to substantial improvements in disease-free survival for patients with HIV. Life-expectancy is approaching that of the general population. Yet these gains have been tempered by increasing rates of non-AIDS-related co-morbidities. In fact the major burden of illness, health care utilization and premature death in HIV positive patients is now due to diseases of ageing. Cardiovascular disease (CVD) occurs at two times the rate in the general population and is a cause of significant morbidity and mortality. Lifestyle factors such as cigarette smoking and underlying genetics are clearly important. Yet in HIV patients CVD is also promoted by complex interactions between HIV and ART driven coagulation, dyslipidaemia, inflammation and immune dysfunction. Understanding the pathogenesis of CVD in HIV will be of increasing importance as the HIV population ages. This will enable targeted prevention strategies and personalised antiretroviral regimens to be utilised. Some of the recent advances in the field are discussed in this review.


References

[1]  Calvo-Sánchez, M. et al. (2013) Differences between HIV-infected and uninfected adults in the contributions of smoking, diabetes and hypertension to acute coronary syndrome: two parallel case-control studies. HIV Med. 14, 40–48.
Differences between HIV-infected and uninfected adults in the contributions of smoking, diabetes and hypertension to acute coronary syndrome: two parallel case-control studies.Crossref | GoogleScholarGoogle Scholar | 23088307PubMed |

[2]  Gritz, E.R. et al. (2013) Long-term outcomes of a cell phone-delivered intervention for smokers living with HIV/AIDS. Clin. Infect. Dis. 57, 608–615.
Long-term outcomes of a cell phone-delivered intervention for smokers living with HIV/AIDS.Crossref | GoogleScholarGoogle Scholar | 23704120PubMed |

[3]  Lo, J. and Plutzky, J. (2012) The biology of atherosclerosis: general paradigms and distinct pathogenic mechanisms among HIV-infected patients. J. Infect. Dis. 205, S368–S374.
The biology of atherosclerosis: general paradigms and distinct pathogenic mechanisms among HIV-infected patients.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xnt1egsrs%3D&md5=f0c9ef0029d29a5571be0fed0bc74c61CAS | 22577210PubMed |

[4]  Kuller, L.H. et al. (2008) Inflammatory and coagulation biomarkers and mortality in patients with HIV infection. PLoS Med. 5, e203.
Inflammatory and coagulation biomarkers and mortality in patients with HIV infection.Crossref | GoogleScholarGoogle Scholar | 18942885PubMed |

[5]  Kaplan, R.C. et al. (2011) T cell activation and senescence predict subclinical carotid artery disease in HIV-infected women. J. Infect. Dis. 203, 452–463.
T cell activation and senescence predict subclinical carotid artery disease in HIV-infected women.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhtVegur8%3D&md5=427178b2b11260e1653313ec6b721f02CAS | 21220772PubMed |

[6]  Westhorpe, C.L. et al. (2013) Associations between surface markers on blood monocytes and carotid atherosclerosis in HIV-positive individuals. Immunol. Cell Biol. 92, 133–138.
| 24296810PubMed |

[7]  Neuhaus, J. et al. (2010) Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection. J. Infect. Dis. 201, 1788–1795.
Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXovVKht7Y%3D&md5=20d59d7b39dc66a1ee79b8474fb03fc2CAS | 20446848PubMed |

[8]  Friis-Moller, N. et al. (2003) Combination antiretroviral therapy and the risk of myocardial infarction. N. Engl. J. Med. 349, 1993–2003.
Combination antiretroviral therapy and the risk of myocardial infarction.Crossref | GoogleScholarGoogle Scholar | 14627784PubMed |

[9]  Worm, S.W. et al. (2010) Risk of myocardial infarction in patients with HIV infection exposed to specific individual antiretroviral drugs from the 3 major drug classes: the data collection on adverse events of anti-HIV drugs (D:A:D) study. J. Infect. Dis. 201, 318–330.
Risk of myocardial infarction in patients with HIV infection exposed to specific individual antiretroviral drugs from the 3 major drug classes: the data collection on adverse events of anti-HIV drugs (D:A:D) study.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXisFGqtLY%3D&md5=817f7428afd82acba75f62843f0fdaedCAS | 20039804PubMed |

[10]  Trevillyan, J.M. et al. (2013) Abacavir exposure and cardiovascular risk factors in HIV-positive patients with coronary heart disease: a retrospective case-control study. Sex. Health 10, 97–101.
Abacavir exposure and cardiovascular risk factors in HIV-positive patients with coronary heart disease: a retrospective case-control study.Crossref | GoogleScholarGoogle Scholar | 23256968PubMed |

[11]  Falcinelli, E. et al. (2013) In vivo platelet activation and platelet hyperreactivity in abacavir-treated HIV-infected patients. Thromb. Haemost. 110, 349–357.
In vivo platelet activation and platelet hyperreactivity in abacavir-treated HIV-infected patients.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhtlCrsrnM&md5=176ce96c5d654623979db8a37a172a38CAS | 23703656PubMed |

[12]  Rose, H. et al. (2008) HIV infection and high density lipoprotein metabolism. Atherosclerosis 199, 79–86.
HIV infection and high density lipoprotein metabolism.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXns1Sntro%3D&md5=4c8b2a124dab3e959a2e98501eea98caCAS | 18054941PubMed |

[13]  Penzak, S.R. and Chuck, S.K. (2000) Hyperlipidemia associated with HIV protease inhibitor use: pathophysiology, prevalence, risk factors and treatment. Scand. J. Infect. Dis. 32, 111–123.
Hyperlipidemia associated with HIV protease inhibitor use: pathophysiology, prevalence, risk factors and treatment.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvktVKnsQ%3D%3D&md5=d4941f52ed0a59e4d92d37c019d85558CAS | 10826894PubMed |