Coronary Artery Disease in HIV-Infected Patients: ClinicalPresentation,Pathophysiology, Prognosis,Prevention,and Treatment

  • F. Boccara
  • C. Meuleman
  • S. Ederhy
  • S. Lang
  • S. Janower
  • A. Cohen
  • F. Raoux


The advent of new antiretroviral agents has dramatically reduced mortality and HIVassociated morbidity. In the highly active antiretroviral therapy (HAART) era, longterm side effects have been reported such as severe metabolic disorders and related acute cardiovascular complications including myocardial infarction, peripheral vascular disease, and stroke. Prevention and therapeutics for cardiovascular complications in HIV-infected patients are a new and emerging challenge for physicians involved in HIV infection care because of the prolongation of survival and long-term complications of HAART. In the present overview, we discuss the clinical presentation, pathophysiology, prognosis, prevention, and treatment of coronary heart disease (CHD) in HIV-infected patients.


Human Immunodeficiency Virus Acute Coronary Syndrome Coronary Angiogram Percutaneous Coronary Interven Protease Inhibitor Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Klein D, Hurley LB, Quesenberry CP J, Sidney S (2002) Do protease inhibitors increase the risk for coronary heart disease in patients with HIV-1 infection? J Acquir Immune Defic Synd 30:471–477Google Scholar
  2. 2.
    Mary-Krause M, Cotte L, Simon A, Partisani M, Costagliola D and the Clinical Epidemiology Group from the French Hospital Database (2003) Increased risk of myocardial infarction with duration of protease inhibitor therapy in HIV-infected men. AIDS 17:2479–2486PubMedGoogle Scholar
  3. 3.
    Friis-Moller N, Sabin CA, Weber R et al (2003) Data Collection on Adverse Events of Anti-HIV Drugs (DAD) Study Group. Combination antiretroviral therapy and the risk of myocardial infarction. N Engl J Med 349:1993–2003Google Scholar
  4. 4.
    Holmberg SD, Hamburger ME, Moorman AC et al (2002) HIV Outpatient Study (HOPS) investigators: protease inhibitors and cardiovascular outcomes in patients with HIV-1. Lancet 360:1747–1748PubMedGoogle Scholar
  5. 5.
    Bozzette SA, Ake CF, Tam HK et al (2003) Cardiovascular and cerebrovascular events in patients treated for human immunodeficiency virus infection. N Engl J Med 348:702–710PubMedGoogle Scholar
  6. 6.
    Henry K, Melroe H, Huebsch J et al (1998) Severe premature coronary artery disease with protease inhibitors. Lancet 351:1328PubMedGoogle Scholar
  7. 7.
    Berhens G, Schmidt H, Meyer D et al (1998) Vascular complications associated with use of HIV protease inhibitors. Lancet 351:1958Google Scholar
  8. 8.
    Gallet B, Pulik M, Genet P et al (1998) Vascular complications associated with use of HIV protease inhibitors. Lancet 351:1958–1959PubMedGoogle Scholar
  9. 9.
    Vittecoq D, Escaut L, Monsuez JJ (1998) Vascular complications associated with use of HIV protease inhibitors. Lancet 351:1959PubMedGoogle Scholar
  10. 10.
    Jutte A, Schwenk A, Franzen C et al (1999) Increasing morbidity from myocardial infarction during HIV protease inhibitor treatment? AIDS 13:1796–1797PubMedGoogle Scholar
  11. 11.
    Rickerts V, Brodt H-R, Staszewski S, Stille W (2000) Incidence of myocardial infarction in HIVinfected patients between 1983 and 1998: the Frankfurt HIV-cohort study. Eur J Med Res 5:329–333PubMedGoogle Scholar
  12. 12.
    Duong M, Cottin Y, Piroth L et al (2002) Exercise stress testing for detection of silent myocardial ischemia in human immunodeficiency virus-infected patients receiving antiretroviral therapy. Clin Infect Dis 34:523–528PubMedGoogle Scholar
  13. 13.
    Boccara F, Ederhy S, Janower S et al (2005) Clinical characteristics and mid-term prognosis of acute coronary syndrome in HIV-infected patients on antiretroviral therapy. HIV Med 6:240–244PubMedGoogle Scholar
  14. 14.
    Friis-Moller N, Reiss P, Sabin CA et al; DAD Study Group,(2007) Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med 356:1723–1735PubMedGoogle Scholar
  15. 15.
    Bergersen BM, Sandvik L, Bruun JN, Tonstad S (2004) Elevated Framingham risk score in HIVpositive patients on highly active antiretroviral therapy: results from a Norwegian study of 721 subjects. Eur J Clin Microbiol Infect Dis 23:625–630PubMedGoogle Scholar
  16. 16.
    Neumann T, Woiwod T, Neumann A et al (2004) Cardiovascular risk factors and probability for cardiovascular events in HIV-infected patients, part III: age differences. Eur J Med Res 9:267–272PubMedGoogle Scholar
  17. 17.
    Hadigan C, Meigs JB, Wilson PW et al (2003) Prediction of coronary heart disease risk in HIV-infected patients with fat redistribution. Clin Infect Dis 36:909–916PubMedGoogle Scholar
  18. 18.
    Knobel H, Jerico C, Montero M et al (2007) Global cardiovascular risk in patients with HIV infection: concordance and differences in estimates according to three risk equations (Framingham, SCORE, and PROCAM). AIDS Patient Care STDS 21:452–457PubMedGoogle Scholar
  19. 19.
    Saves M, Chene G, Ducimetiere P et al (2003) French WHO MONICA Project and the APROCO (ANRS EP11) Study Group: risk factors for coronary heart disease in patients treated for human immunodeficiency virus infection compared with the general population. Clin Infect Dis 37:292–298PubMedGoogle Scholar
  20. 20.
    Glass TR, Ungsedhapand C, Wolbers M et al; Swiss HIV Cohort Study (2006) Prevalence of risk factors for cardiovascular disease in HIV-infected patients over time: the Swiss HIV Cohort Study. HIV Med. 7:404–410PubMedGoogle Scholar
  21. 21.
    Sterne JA, May M, Bucher HC et al; Swiss HIV Cohort (2007) HAART and the heart: changes in coronary risk factors and implications for coronary risk in men starting antiretroviral therapy. J Intern Med 261:255–267PubMedGoogle Scholar
  22. 22.
    Bergersen BM (2006) Cardiovascular risk in patients with HIV Infection: impact of antiretroviral therapy. Drugs 66:1971–1987PubMedGoogle Scholar
  23. 23.
    Grinspoon S, Carr A (2005) Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med 352:48–62PubMedGoogle Scholar
  24. 24.
    Sudano I, Spieker LE, Noll G et al (2006) Cardiovascular disease in HIV infection. Am Heart J 151:1147–1155PubMedGoogle Scholar
  25. 25.
    Triant VA, Lee H, Hadigan C, Grinspoon SK (2007) Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab 92:2506–2512PubMedGoogle Scholar
  26. 26.
    Carr A, Samaras K, Thorisdottir A et al (1999) Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor-associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet 353:2093–2099PubMedGoogle Scholar
  27. 27.
    Piériard D, Telenti A, Sudre P et al (1999) Atherogenic dyslipidemia in HIV-infected individuals treated with protease inhibitors: the Swiss HIV Cohort Study. Circulation 100:700–705Google Scholar
  28. 28.
    Fichtenbaum CJ, Gerber JG, Rosenkranz SL et al (2002) NIAID AIDS Clinical Trials Group. Pharmacokinetic interactions between protease inhibitors and statins in HIV seronegative volunteers: ACTG Study A5047. AIDS 16:569–577Google Scholar
  29. 29.
    Dube MP, Stein JH, Aberg JA et al; Adult AIDS Clinical Trials Group Cardiovascular Subcommittee (2003) Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy: recommendations of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group. Clin Infect Dis 37:613–627PubMedGoogle Scholar
  30. 30.
    Stein JH, Merwood MA, Bellehumeur JL et al (2004) Effects of pravastatin on lipoproteins and endothelial function in patients receiving human immunodeficiency virus protease inhibitors. Am Heart J 147:713Google Scholar
  31. 31.
    Asztalos BF, Schaefer EJ, Horvath KV et al (2006) Protease inhibitor-based HAART, HDL, and CHDrisk in HIV-infected patients. Atherosclerosis 184:72–77PubMedGoogle Scholar
  32. 32.
    Grinspoon SK (2005) Metabolic syndrome and cardiovascular disease in patients with human immunodeficiency virus. Am J Med 118(Suppl 2):23S–28SPubMedGoogle Scholar
  33. 33.
    Khan NA, Di Cello F, Nath A, Kim KS (2003) Human immunodeficiency virus type 1 Tat-mediated cytotoxicity of human brain microvascular endothelial cells. J Neurovirol 9:584–593PubMedGoogle Scholar
  34. 34.
    Schecter AD, Berman AB, Yi L, Mosoian A et al (2001) HIV envelope gp120 activates human arterial smooth muscle cells. Proc Natl Acad Sci 98:10142–10147PubMedGoogle Scholar
  35. 35.
    Coll B, Parra S, Alonso-Villaverde C et al (2006) HIV-infected patients with lipodystrophy have higher rates of carotid atherosclerosis: the role of monocyte chemoattractant protein-1. Cytokine 34:51–55PubMedGoogle Scholar
  36. 36.
    de Larranaga GF, Petroni A, Deluchi G et al (2003) Viral load and disease progression as responsible for endothelial activation and/or injury in human immunodeficiency virus-1-infected patients. Blood Coagul Fibrinolysis 14:15–18PubMedGoogle Scholar
  37. 37.
    Fisher SD, Miller TL, Lipshultz SE (2006) Impact of HIV and highly active antiretroviral therapy on leukocyte adhesion molecules, arterial inflammation, dyslipidemia, and atherosclerosis. Atherosclerosis 185:1–11PubMedGoogle Scholar
  38. 38.
    Stein JH, Klein MA, Bellehumeur JL et al (2001) Use of human immunodeficiency virus-1 protease inhibitors is associated with atherogenic lipoprotein changes and endothelial dysfunction. Circulation 104:257–262PubMedGoogle Scholar
  39. 39.
    Hulgan T, Morrow J, D’Aquila RT et al (2003) Oxidant stress is increased during treatment of human immunodeficiency virus infection. Clin Infect Dis 37:1711–1717PubMedGoogle Scholar
  40. 40.
    de Gaetano Donati K, Rabagliati R, Iacoviello L, Cauda R (2004) HIV infection, HAART, and endothelial adhesion molecules: current perspectives. Lancet Infect Dis 4:213–222PubMedGoogle Scholar
  41. 41.
    Wu RF, Gu Y, Xu YC et al (2004) Human immunodeficiency virus type 1 Tat regulates endothelial cell actin cytoskeletal dynamics through PAK1 activation and oxidant production. J Virol 78:779–789PubMedGoogle Scholar
  42. 42.
    Hsue PY, Hunt PW, Sinclair E et al (2006) Increased carotid intima-media thickness in HIV patients is associated with increased cytomegalovirusspecific T-cell responses. AIDS 20:2275–2283PubMedGoogle Scholar
  43. 43.
    Zandman-Goddard G, Shoenfeld Y (2002) HIV and autoimmunity. Autoimmun Rev 1:329–337PubMedGoogle Scholar
  44. 44.
    Karmochkine M, Ankri A, Calvez V et al (1998) Plasma hypercoagulability is correlated to plasma HIV load. Thromb Haemost 80:208–209PubMedGoogle Scholar
  45. 45.
    Escaut L, Monsuez JJ, Chironi G et al (2003) Coronary artery disease in HIV infected patients. Intensive Care Med 29:969–973PubMedGoogle Scholar
  46. 46.
    David MH, Hornung R, Fichtenbaum CJ (2002) Ischemic cardiovascular disease in persons with human immunodeficiency virus infection. Clin Infect Dis 34:98–102PubMedGoogle Scholar
  47. 47.
    Barbaro G, Barbarini G, Pellicelli AM (2001) HIV associated coronary arteritis in a patient with fatal myocardial infarction. N Engl J Med 344:1799–1800PubMedGoogle Scholar
  48. 48.
    Tabib A, Leroux C, Mornex JF, Loire R (2000) Accelerated coronary atherosclerosis and arteriosclerosis in young human-immunodeficiencyviruspositive patients. Coron Artery Dis 11:41–46PubMedGoogle Scholar
  49. 49.
    Hsue PY, Lo JC, Franklin A et al (2004) Progression of atherosclerosis as assessed by carotid intimamedia thickness in patients with HIV infection. Circulation 109:1603–1608PubMedGoogle Scholar
  50. 50.
    Mercie P, Thiebaut R, Lavignolle V et al (2002) Evaluation of cardiovascular risk factors in HIV-1 infected patients using carotid intima-media thickness measurement. Ann Med 34:55–63PubMedGoogle Scholar
  51. 51.
    Depairon M, Chessex S, Sudre P et al (2001) Premature atherosclerosis in HIV-infected individuals: focus on protease inhibitor therapy. AIDS 15:329–334PubMedGoogle Scholar
  52. 52.
    Maggi P, Serio G, Epifani G et al (2000) Premature lesions of the carotid vessels in HIV-1-infected patients treated with protease inhibitors. AIDS 14:F123–128PubMedGoogle Scholar
  53. 53.
    Seminari E, Pan A, Voltini G et al (2002) Assessment of atherosclerosis using carotid ultrasonography in a cohort of HIV-positive patients treated with protease inhibitors. Atherosclerosis 162:433–438PubMedGoogle Scholar
  54. 54.
    Jerico C, Knobel H, Calvo N et al (2006) Subclinical carotid atherosclerosis in HIV-infected patients: role of combination antiretroviral therapy. Stroke 37:812–817PubMedGoogle Scholar
  55. 55.
    de Saint Martin L, Vandhuick O, Guillo P et al (2006) Premature atherosclerosis in HIV positive patients and cumulated time of exposure to antiretroviral therapy (SHIVA study). Atherosclerosis 185:361–367PubMedGoogle Scholar
  56. 56.
    Mangili A, Gerrior J, Tang AM et al (2006) Risk of cardiovascular disease in a cohort of HIV-infected adults: a study using carotid intima-media thickness and coronary artery calcium score. Clin Infect Dis 43:1482–1489PubMedGoogle Scholar
  57. 57.
    Matetzky S, Domingo M, Kar S et al (2003) Acute myocardial infarction in human immunodeficiency virus-infected patients. Arch Intern Med 163:457–460PubMedGoogle Scholar
  58. 58.
    Hsue PY, Giri K, Erickson S et al (2004) Clinical features of acute coronary syndromes in patients with human immunodeficiency virus infection. Circulation 109:316–319PubMedGoogle Scholar
  59. 59.
    Ambrose JA, Gould RB, Kurian DC et al (2003) Frequency of and outcome of acute coronary syndromes in patients with human immunodeficiency virus infection. Am J Cardiol 92:301–303PubMedGoogle Scholar
  60. 60.
    Varriale P, Saravi G, Hernandez E, Carbon F (2004) Acute myocardial infarction in patients infected with human immunodeficiency virus. Am Heart J 147:55–59PubMedGoogle Scholar
  61. 61.
    Boccara F, Teiger E, Cohen A et al (2006) Percutaneous coronary intervention in HIV infected patients: immediate results and long term prognosis. Heart 92:543–544PubMedGoogle Scholar
  62. 62.
    Boccara F, Mary-Krause M, Teiger E et al (2007) Clinical and angiographic features of acute coronary syndromes in HIV-infected compared with non-HIV-infected patients. 14th Conference on Retroviruses and Opportunistic Infectious, Los Angeles, Feb 2007, Abstract no. 811Google Scholar
  63. 63.
    Lauer MS (2002) Aspirin for primary prevention of coronary events. N Engl J Med 346:1468–1474PubMedGoogle Scholar
  64. 64.
    Preventive services task force (2002) Aspirin for the primary prevention of cardiovascular events: recommendation and rationale. Ann Intern Med 136:157–160Google Scholar
  65. 65.
    Wood D, De Backer G, Faergeman O et al (1998) Prevention of coronary heart disease in clinical practice: recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention. Atherosclerosis 140:199–270PubMedGoogle Scholar
  66. 66.
    Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (adults treatment panel III). JAMA 285:2486–2497Google Scholar
  67. 67.
    Fichtenbaum CJ, Gerber JG, Rosenkranz SL et al (2002) Pharmacokinetic interactions between protease inhibitors and statins in HIV seronegative volunteers: ACTG Study A5047. AIDS 16:569–577PubMedGoogle Scholar
  68. 68.
    Benesic A, Zilly M, Kluge F et al (2004) Lipid lowering therapy with fluvastatin and pravastatin in patients with HIV infection and antiretroviral therapy: comparison of efficacy and interaction with indinavir. Infection 32:229–333PubMedGoogle Scholar
  69. 69.
    Calza L, Colangeli V, Manfredi R et al (2005) Rosuvastatin for the treatment of hyperlipidaemia in HIV-infected patients receiving protease inhibitors: a pilot study. AIDS 19:1103–1105PubMedGoogle Scholar
  70. 70.
    Palacios R, Santos J, Gonzalez M et al (2002) Efficacy and safety of atorvastatin in the treatment of hypercholesterolemia associated with antiretroviral therapy. J Acquir Immune Defic Syndr 30:536–537PubMedGoogle Scholar
  71. 71.
    Calza L, Manfredi R, Chiodo F (2002) Use of fibrates in the management of hyperlipidemia in HIV-infected patients receiving HAART. Infection 30:26–31PubMedGoogle Scholar
  72. 72.
    Dube MP, Wu JW, Aberg JA et al; AIDS Clinical Trials Group A5148 Study Team (2006) Safety and efficacy of extended-release niacin for the treatment of dyslipidaemia in patients with HIV infection: AIDS Clinical Trials Group Study A5148. Antivir Ther 11:1081–1089PubMedGoogle Scholar
  73. 73.
    Negredo E, Molto J, Puig J et al (2006) Ezetimibe, a promising lipid-lowering agent for the treatment of dyslipidaemia in HIV-infected patients with poor response to statins. AIDS 20:2159–2164PubMedGoogle Scholar
  74. 74.
    Van der Valk M, Kastelein JJ, Murphy RL et al (2001) Nevirapine-containing antiretroviral therapy in HIV-1 infected patients results in an antiatherogenic lipid profile. AIDS 15:2407–2414PubMedGoogle Scholar
  75. 75.
    Negredo E, Ribalta J, Paredes R et al (2002) Reversal of atherogenic lipoprotein profile in HIV-1 infected patients with lipodystrophy after replacing protease inhibitors by nevirapine. AIDS 16:1383–1389PubMedGoogle Scholar
  76. 76.
    Parienti JJ, Massari V, Rey D et al; SIROCCO study team (2007) Efavirenz to nevirapine switch in HIV-1-infected patients with dyslipidemia: a randomized, controlled study. Clin Infect Dis 45:263–266PubMedGoogle Scholar
  77. 77.
    Mobius U, Lubach-Ruitman M, Castro-Frenzel B et al (2005) Switching to atazanavir improves metabolic disorders in antiretroviral-experienced patients with severe hyperlipidemia. J Acquir Immune Defic Syndr 39:174–180PubMedGoogle Scholar
  78. 78.
    Llibre JM, Domingo P, Palacios R et al; Lipo-Rec Study Group (2006) Sustained improvement of dyslipidaemia in HAART-treated patients replacing stavudine with tenofovir. AIDS 20:1407–1414PubMedGoogle Scholar
  79. 79.
    Niaura R, Shadel WG, Morrow K et al (2000) Human immunodeficiency virus infection, AIDS, and smoking cessation: the time is now. Clin Infect Dis 31:808–812PubMedGoogle Scholar
  80. 80.
    Louie JK, Hsu LC, Osmond DH et al (2002) Trends in causes of death among persons with acquired immunodeficiency syndrome in the era of highly active antiretroviral therapy, San Francisco, 1994–1998. J Infect Dis 186:1023–1027PubMedGoogle Scholar
  81. 81.
    Elzi L, Spoerl D, Voggensperger J et al; Swiss HIV Cohort Study (2006) A smoking cessation programme in HIV-infected individuals: a pilot study. Antivir Ther 11:787–1795PubMedGoogle Scholar
  82. 82.
    The Writing Group for the Activity Counseling Trial Research Group (2001) Effects of physical activity counseling in primary care: the Activity Counseling Trial: a randomized controlled trial. JAMA 286:677–687Google Scholar
  83. 83.
    Stewart KJ (2002) Exercise training and the cardiovascular consequences of type 2 diabetes and hypertension: plausible mechanisms for improving cardiovascular health. JAMA 288:1622–1631PubMedGoogle Scholar
  84. 84.
    Roubenoff R, Schmitz H, Bairos L et al (2002) Reduction of abdominal obesity in lipodystrophy associated with human immunodeficiency virus infection by means of diet and exercise: case report and proof of principle. Clin Infect Dis 34:390–393PubMedGoogle Scholar
  85. 85.
    Moyle G, Baldwin C, Phillpot M (2001) Managing metabolic disturbances and lipodystrophy: diet, exercise, and smoking advice. AIDS Read 11:589–592PubMedGoogle Scholar
  86. 86.
    Thoni GJ, Fedou C, Brun JF et al (2002) Reduction of fat accumulation and lipid disorders by individualized light aerobic training in human immunodeficiency virus infected patients with lipodystrophy and/or dyslipidemia. Diabetes Metab 28:397–404PubMedGoogle Scholar
  87. 87.
    Barbaro G, Fisher SD, Lipshultz SE (2001) Pathogenesis of HIV-associated cardiovascular complications. Lancet Infect Dis 1:115–124PubMedGoogle Scholar
  88. 88.
    Lewis W (2001) AIDS cardiomyopathy: physiological, molecular, and biochemical studies in the transgenic mouse. Ann N Y Acad Sci 946:46–56PubMedCrossRefGoogle Scholar
  89. 89.
    Nakai K, Itoh C, Nakai K et al (2001) Correlation between C677T MTHFR gene polymorphism, plasma homocysteine levels and the incidence of CAD. Am J Cardiovasc Drugs 1:353–361PubMedGoogle Scholar
  90. 90.
    Vilaseca MA, Sierra C, Colome C et al (2001) Hyperhomocysteinaemia and folate deficiency in human immunodeficiency virus-infected children. Eur J Clin Invest 31:992–998PubMedGoogle Scholar
  91. 91.
    Cohn JE (2001) Homocysteine, HIV, and heart disease. AIDS Treat News 370:5–6PubMedGoogle Scholar
  92. 92.
    Bernasconi E, Uhr M, Magenta L et al (2001) Swiss HIV Cohort Study: homocysteinaemia in HIV-infected patients treated with highly active antiretroviral therapy. AIDS 15:1081–1082PubMedGoogle Scholar
  93. 93.
    Dube MP (2003) Disorders of glucose metabolism in patients infected with human immunodeficiency virus. Clin Infect Dis 31:1467–1475Google Scholar
  94. 94.
    Walli R, Herfort O, Michl GM et al (1998) Treatment with protease inhibitors associated with peripheral insulin resistance and impaired oral glucose tolerance in HIV-1-infected patients. AIDS 12:F167–173PubMedGoogle Scholar
  95. 95.
    Florescu D, Kotler DP (2007) Insulin resistance, glucose intolerance and diabetes mellitus in HIV-infected patients. Antivir Ther 12:149–162PubMedGoogle Scholar
  96. 96.
    Carr A, Samaras K, Burton S et al (1998) A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS 12(Suppl F):51–58Google Scholar
  97. 97.
    Mallon PW, Wand H, Law M et al (2005) Buffalo hump seen in HIV-associated lipodystrophy is associated with hyperinsulinemia but not dyslipidemia. J Acquir Immune Defic Syndr 38:156–162PubMedGoogle Scholar
  98. 98.
    Shlay JC, Visnegarwala F, Bartsch G et al (2005) Body composition and metabolic changes in antiretroviralnaïve patients randomised to didanosine and stavudine vs abacavir and lamivudine. J Acquir Immune Defic Syndr 38:147–155PubMedGoogle Scholar
  99. 99.
    Guffanti M, Caumo A, Galli L et al (2007) Switching to unboosted atazanavir improves glucose tolerance in highly pretreated HIV-1 infected subjects. European Journal of Endocrinology 156:503–509PubMedGoogle Scholar
  100. 100.
    Henry P, Thomas F, Benetos A, Guize L (2002) Impaired fasting glucose, blood pressure and cardiovascular disease mortality. Hypertension 40:458–463PubMedGoogle Scholar
  101. 101.
    Hadigan C, Rabe J, Grinspoon S (2002) Sustained benefits of metformin therapy on markers of cardiovascular risk in human immunodeficiency virus-infected patients with fat redistribution and insulin resistance. J Clin Endocrinol Metab 87:4611–4615PubMedGoogle Scholar
  102. 102.
    Hadigan C, Corcoran C, Basgoz N et al (2000) Metformin in the treatment of HIV lipodystrophy syndrome: a randomized controlled trial. JAMA 284:472–477PubMedGoogle Scholar
  103. 103.
    Grinspoon S (2007) Use of thiazolidinediones in HIV-infected patients: what have we learned? J Infect Dis 195:1731–1733PubMedGoogle Scholar
  104. 104.
    Yki-Jarvinen H, Sutinen J, Silveira A et al (2003) Regulation of plasma PAI-1 concentrations in HAART-associated lipodystrophy during rosiglitazone therapy. Arterioscler Thromb Vasc Biol 23:688–694PubMedGoogle Scholar
  105. 105.
    Morse CG, Kovacs JA (2006) Metabolic and skeletal complications of HIV infection: the price of success. JAMA 296:844–854PubMedGoogle Scholar
  106. 106.
    Sattler FR, Qian D, Louie S et al (2001) Elevated blood pressure in subjects with lipodystrophy. AIDS 15:2001–2010PubMedGoogle Scholar
  107. 107.
    Jung O, Bickel M, Ditting T et al (2004) Hypertension in HIV-1-infected patients and its impact on renal and cardiovascular integrity. Nephrol Dial Transplant 19:2250–2258PubMedGoogle Scholar
  108. 108.
    Crane HM, Van Rompaey SE, Kitahata MM (2006) Antiretroviral medications associated with elevated blood pressure among patients receiving highly active antiretroviral therapy. AIDS 20:1019–1026PubMedGoogle Scholar
  109. 109.
    Chobanian AV, Bakris GL, Black HR et al; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee (2003) The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289:2560–2572PubMedGoogle Scholar
  110. 110.
    Hamm CW, Bertrand M, Braunwald E (2001) Acute coronary syndrome without ST elevation: implementation of new guidelines. Lancet 358:1533–1538PubMedGoogle Scholar
  111. 111.
    Antman EM, Anbe DT, Armstrong PW et al (2004) ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction). J Am Coll Cardiol 44:671–719PubMedGoogle Scholar
  112. 112.
    Volberding PA, Murphy RL, Barbaro G et al (2003) The Pavia consensus statement. AIDS 17(Suppl 1):S170–S179PubMedGoogle Scholar
  113. 113.
    Trachiotis GD, Alexander EP, Benator D, Gharagozloo F (2003) Cardiac surgery in patients infected with the human immunodeficiency virus. Ann Thorac Surg 76:1114–1118PubMedGoogle Scholar
  114. 114.
    Halpern SD, Ubel PA, Caplan AL (2002) Solid-organ transplantation in HIV-infected patients. N Engl J Med 347:284–287PubMedGoogle Scholar
  115. 115.
    Morgan JA, Bisleri G, Mancini DM (2003) Cardiac transplantation in an HIV-1-infected patient. N Engl J Med 349:1388–1389PubMedGoogle Scholar
  116. 116.
    Bisleri G, Morgan JA, Deng MC et al (2003) Should HIV-positive recipients undergo heart transplantation? J Thorac Cardiovasc Surg 126:1639–1640PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • F. Boccara
    • 1
  • C. Meuleman
    • 1
  • S. Ederhy
    • 1
  • S. Lang
    • 1
  • S. Janower
    • 1
  • A. Cohen
    • 1
  • F. Raoux
    • 1
  1. 1.Département de CardiologieAssistance Publique-Hôpitaux de Paris et Université Pierre et Marie Curie, Centre Hospitalier Universitaire Saint-AntoineParisFrance

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