The Causes of HIV-Associated Cardiomyopathy: A Tale of Two Worlds.

Published

Journal Article (Review)

Antiretroviral therapy (ART) has transformed the clinical profile of human immunodeficiency virus (HIV) from an acute infection with a high mortality into a treatable, chronic disease. As a result, the clinical sequelae of HIV infection are changing as patients live longer. HIV-associated cardiomyopathy (HIVAC) is a stage IV, HIV-defining illness and remains a significant cause of morbidity and mortality among HIV-infected individuals despite ART. Causes and clinical manifestations of HIVAC depend on the degree of host immunosuppression. Myocarditis from direct HIV toxicity, opportunistic infections, and nutritional deficiencies are implicated in causing HIVAC when HIV viral replication is unchecked, whereas cardiac autoimmunity, chronic inflammation, and ART cardiotoxicity contribute to HIVAC in individuals with suppressed viral loads. The initiation of ART has dramatically changed the clinical manifestation of HIVAC in high income countries from one of severe, left ventricular systolic dysfunction to a pattern of subclinical cardiac dysfunction characterized by abnormal diastolic function and strain. In low and middle income countries, however, HIVAC is the most common HIV-associated cardiovascular disease. Clear diagnostic and treatment guidelines for HIVAC are currently lacking but should be prioritized given the global burden of HIVAC.

Full Text

Duke Authors

Cited Authors

  • Lumsden, RH; Bloomfield, GS

Published Date

  • January 17, 2016

Published In

Volume / Issue

  • 2016 /

Start / End Page

  • 8196560 -

PubMed ID

  • 26885518

Pubmed Central ID

  • 26885518

Electronic International Standard Serial Number (EISSN)

  • 2314-6141

International Standard Serial Number (ISSN)

  • 2314-6133

Digital Object Identifier (DOI)

  • 10.1155/2016/8196560

Language

  • eng