HIV and Cardiovascular Disease: Update on Clinical Events, Special Populations, and Novel Biomarkers

Abstract

Purpose of review: The objective of this review is to provide an update on the link between HIV infection and cardiovascular disease (CVD). We will focus our review mainly on literature describing clinical CVD events and understudied topics of importance.

Recent findings: Heart failure, peripheral artery disease, and stroke are CVD modalities deserving more attention in the context of HIV infection in the highly active antiretroviral therapy era. Incidence data on clinical CVD from HIV populations in low- and middle-income countries are limited. Multisubstance use is common in HIV, but understudied as a moderator or mediator of the association between HIV and CVD. CVD risk assessment in HIV remains challenging, but new research into novel biomarkers may provide further insights. There is also a need for inclusion of non-biologic factors in our attempts to understand, quantify, and predict CVD risk among PLWHA. Significant attention has been paid to generating and testing hypotheses to understand the mechanisms of myocardial infarction in HIV. Similar attention is deserving for heart failure, PAD, stroke, and cardiovascular disease risk in resource-limited settings and among substance users with HIV.

Keywords: CVD; CVD risk; Cardiovascular disease; HIV; PLWHA; Review.

Fig. 1

a 2016 HIV/AIDS death rates. b 2006–2016 annual percentage increase in HIV/AIDS death rates, c)i) 2016 prevalence and incidence rates of HIV/AIDS; c)ii) 2006–2016 annual percentage increase in prevalence and incidence rates of HIV/AIDS d)i) 2016 prevalence and incidence rates of CVD; d)ii) 2006–2016 annual percentage increase in prevalence and incidence rates of CVD. Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, 2016. Available from https://vizhub.healthdata.org/gbd-compare/. (Accessed December 4, 2016)