Epidemiology and pathogenesis of human immunodeficiency virus (HIV) related heart disease: a review.

BACKGROUND

There is a clear and growing body of evidence for cardiac dysfunction in a significant portion of patients with HIV disease. An increased number of HIV-infected individuals may present with cardiac complications in the future as more patients with this disease survive longer because of modern therapy. Heart involvement in AIDS may be well characterized cardiac disease occurring coincidentally in AIDS patients, a complication of the disease or its treatment or possibly a direct insult to the heart by the HIV itself.

METHODS

We reviewed the literature on heart disease in HIV infection and AIDS with particular reference to epidemiology and pathogenetic mechanisms that may play a role in diagnosis, management, and therapy of these complications. The MEDLINE/PUBMED and bibliographic searches forEnglish language studies were used.

RESULTS

A variety of potential aetiologies have been postulated in HIV-related heart disease, including myocardial invasion with HIV itself, opportunistic infections, viral infections, autoimmune response to viral infection, drug-related cardiac toxicity, nutritional deficiencies, and prolonged immunosuppression.

CONCLUSION

An increased number of HIV-infected individuals present with cardiac complications as chronic viral infection, co-infections, drug therapy, and immunosuppression. Understanding the nature and course of cardiac illness related to HIV infection may allow appropriate monitoring, early intervention and therapy