Evolution and Pathogenesis of the Involvement of the Cardiovascular System in HIV Infection
Cardiac illness related to human immunodeficiency virus (HIV) infection tends to occur late in the disease course and is therefore becoming more prevalent as therapy of the viral infection and longevity improve. Autopsy series and retrospective analyses performed before the introduction of highly active antiretroviral therapy (HAART) regimens suggest that cardiac lesions are present in 25–75% of patients with acquired immunodeficiency syndrome (AIDS) . HAART regimens have significantly modified the course of HIV disease, with longer survival rates and improvement of life quality in HIV-infected subjects expected. However, early data raised concerns about HAART being associated with an increase in both peripheral and coronary arterial diseases. HAART is only available to a minority of HIV-infected individuals worldwide, and studies prior to HAART therapy remain globally applicable. As 36.1 million adults and children are estimated to be living with HIV/AIDS and 5.3 million adults and children are estimated to have been newly infected with HIV during the year 2000 , HIV-associated symptomatic heart failure may become one of the leading causes of heart failure worldwide. A variety of potential etiologies have been postulated for HIVrelated heart disease, including myocardial infection with HIV itself, opportunistic infections, viral infections, autoimmune response to viral infection, drug-related cardiotoxicity, nutritional deficiencies, and prolonged immunosuppression (Table 1).
KeywordsInfective Endocarditis Pericardial Effusion Simian Immunodeficiency Virus Idiopathic Dilate Cardiomyopathy Myocardial Infection
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