Etiology and pathophysiology of heart failure in people with HIV

Harry Choi, Amit K. Dey, Gaurav Sharma, Rahul Bhoite, Greer Burkholder, Savitri Fedson, Hani Jneid

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

HIV-associated cardiomyopathy is a well-established sequela in people infected with HIV (PHIV). Despite significant advances in HIV management through the use of highly active anti-retroviral therapy (HAART), PHIV on HAART continue to have elevated risk of cardiomyopathy and heart failure, even when accounting for known cardiovascular risk factors. This review article will explore the proposed mechanisms by which chronic HIV infection induces cardiomyopathy and heart failure in the setting of HAART. Evaluation, work-up, and management of cardiomyopathy in PHIV will also be briefly discussed. The advent of HAART has altered the pathophysiology HIV-associated cardiomyopathy from a rapidly progressive cardiomyopathy, often with pericardial involvement, into a chronic process involving inflammation and persistent immune dysregulation. With the significant decrease in AIDS-related deaths, the prevalence of cardiomyopathy and the mortality associated with heart failure in PHIV have increased. Multiple immune-related and inflammatory mechanisms have been proposed, which may provide insight into evaluation and management of cardiomyopathy in PHIV.

Original languageEnglish (US)
Pages (from-to)497-505
Number of pages9
JournalHeart Failure Reviews
Volume26
Issue number3
DOIs
StatePublished - May 2021
Externally publishedYes

Keywords

  • HAART
  • HIV
  • Heart failure
  • Inflammation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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