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Volume 15, Supplement 1 - 2014

Volume 15, Supplement 1 - 2014

Table of Contents

Epidemiology of Coronary Heart Disease in Patients With Human Immunodeficiency Virus HIV and Coronary Heart DIsease
As a growing number of patients infected with human immunodeficiency virus (HIV) have access to antiretroviral therapy and achieve virologic suppression, the focus of clinical care is shifting from treating the infectious complications of advanced immunodeficiency to managing and preventing chronic disease. The aging of the HIV-positive population and increased rates of chronic disease complications in the setting of HIV infection have increased the impact of noncommunicable diseases such as coronary heart disease (CHD). The effect of HIV on CHD is independent of traditional cardiovascular risk factors and antiretroviral medications and is likely due in part to the chronic inflammation and immune activation underlying HIV infection. This article describes the current state of epidemiologic knowledge on CHD in HIV infection. It highlights key studies in the field and summarizes epidemiologic data with respect to traditional and novel CHD risk factors, specialized clinical subgroups, and broader cardiovascular outcomes. [ Rev Cardiovasc Med. 2014;15(suppl 1):S1-S8 doi: 10.3908.ricm15S1S002] © 2014 MedReviews®, LLC
Highly Active Antiretroviral Therapy–related Mechanisms of Endothelial and Platelet Function Alterations HIV and Coronary Heart DIsease
Highly active antiretroviral therapy (HAART) has transformed human immunodeficiency virus (HIV) infection into a chronic condition, which has allowed the infected population to age and become prone to chronic degenerative diseases common to the general population, including atherosclerotic cardiovascular disease, and coronary artery disease (CAD). Possible causative mechanisms of HIV-associated CAD are related to classic cardiovascular risk factors, such as dyslipidemia, insulin resistance, and fat redistribution, which may be due to either HIV infection or to HAART-associated toxicity. However, other mechanisms are emerging as crucial for the cardiovascular complication of HIV and HAART. This article analyzes the effects of HIV and HAART on endothelial function, endothelium-leukocyte interactions, and platelets as possible mechanisms of enhanced cardiovascular risk. [Rev Cardiovasc Med. 2014;15(suppl 1):S9-S20 doi: 10.3908.ricm15S1S004] © 2014 MedReviews® LLC
Impact of Nucleoside Reverse Transcriptase Inhibitors on Coronary Heart Disease HIV and Coronary Heart DIsease
The nucleoside and nucleotide reverse transcriptase inhibitor (N[t]RTI) drug class remains an integral component of effective antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection. However, these drugs are associated with toxicities, through their off-target effects, that may significantly contribute to a number of long-term comorbidities, including coronary artery disease (CAD) and myocardial infarction (MI), recognized to occur with increased frequency in those with HIV undergoing treatment with ART. The contribution of N(t)RTI to CAD and MI may arise either indirectly through induction of metabolic toxicities such as dyslipidemia and insulin resistance, or directly through impact on pathologic pathways involved in development of MI, such as altered platelet responsiveness or endothelial dysfunction. This review focuses on the available data relating to use of individual N(t)RTI drugs and the drug class as a whole and CAD, with a focus on MI. [Rev Cardiovasc Med. 2014;15(suppl 1):S21-S29 doi: 10.3908.ricm15S1S005] © 2014 MedReviews®, LLC
Impact of Antiretroviral Medications on Fasting Lipid Parameters HIV and Coronary Heart DIsease
It is widely accepted that metabolic disease in human immunodeficiency virus (HIV) develops at the intersection of traditional risk factors and HIV-specific contributors, but in observational studies it is difficult to dissect the contribution of the two. This review describes the metabolic impact of antiretroviral medications recommended in the first-line treatment in HIV-infected naive patients. At a clinical level, coronary heart disease screening and management will continue to be of paramount importance in the long-term management of HIV-positive patients on antiretroviral therapy. [Rev Cardiovasc Med. 2014;15(suppl 1):S30-S37 doi: 10.3908.ricm15S1S003] © 2014 MedReviews®, LLC
Management of Dyslipidemia in Patients With Human Immunodeficiency Virus HIV and Coronary Heart DIsease
Dyslipidemias are more common in the patient population with human immunodeficiency virus (HIV). Combination antiretroviral therapy (ART) has dramatically reduced HIV-associated morbidity and mortality and has transformed HIV disease into a chronic, manageable condition. As a result, non–AIDS-related illnesses, including cardiovascular diseases, are now the leading causes of death in the HIV-infected population. Optimizing fasting lipid parameters plays an important role in reducing cardiovascular risk in this population. This review focuses on the management of dyslipidemia in HIV-infected individuals treated with combination ART. [ Rev Cardiovasc Med. 2014;15(suppl 1):S38-S46 doi: 10.3908.ricm15S1S001] © 2014 MedReviews®, LLC