Correlation of human immunodeficiency virus and antiretroviral therapy with cardiac disorders

Abstract

The occurrence of cardiovascular illness in the human immunodeficiency virus (HIV) community is increasing, with a particular focus on coronary heart disease. Patients infected with HIV have a higher risk of myocardial infarction compared to the general population in modern countries due to the development of effective antiretroviral medications and increased life expectancy. Those not receiving highly active antiretroviral therapy (ART) may experience common cardiac consequences, including myocarditis, dilated cardiomyopathy, endocarditis, pulmonary hypertension, pericardial effusion, and cardiotoxicity associated with non-antiretroviral drugs. After the use of highly active ART, continuing immune activation and systemic inflammation seem to play a central role in this process. Recent studies suggest that protease inhibitors might negatively impact the progression of HIV-related heart failure (HF), which complicates the determination of the best therapy strategy for HIV-associated cardiomyopathy. The objective of this review is to examine the pathophysiology and correlation of various antiretroviral drugs leading to HIV-associated HF. Additionally, we explore the causes of HIV-associated atherosclerotic cardiovascular disease, including the high frequency of classic cardiovascular risk factors in HIV-infected patients, as well as HIV-related factors like the use of ART and chronic inflammation despite successful treatment of HIV infection. Numerous studies have revealed that individuals living with HIV/acquired immune deficiency syndrome frequently experience HF. In conclusion, despite advancements in HIV care, HIV-infected individuals continue to face an increased risk of HIV-associated cardiomyopathy and atherosclerosis. Further research is necessary to comprehend the underlying causes and develop effective treatments for cardiovascular disease in this population. We also discuss the currently available therapeutic options and ongoing research to mitigate the risk of cardiovascular disease and inflammation in HIV-infected individuals.