• CAD and ACS:
    • Both HIV and anti-retroviral medications increase patients’ risk of cardiovascular disease
    • HIV-infected patients tend to have a first episode of ACS at age 48 yrs, 10 years earlier than HIV negative patients
    • Reasons for increased risk include higher rates of smoking in HIV+ patients (2-3 times greater than in general population) and accelerated atherosclerosis 2/2 chronic inflammation from HIV itself
    • Some antiretroviral medications can cause insulin resistance and dyslipidemia, further increasing HIV-positive patients risk for CAD
  • Arrhythmias:
    • HIV/AIDS patients are also predisposed to arrhythmias (AF, QTc prolongation) which may be partly related to the effects of HIV on cardiac innervation and the autonomic nervous system
  • Cardiomyopathy/Myopericarditis:
    • Patients with AIDS can also develop a dilated cardiomyopathy or myocarditis 2/2 opportunistic infections (Toxoplasma, Cryptococcus, Candida, Aspergillus, etc.)
    • AIDS patients are also at increased risk for pericardial effusions (2/2 malignancies such as Non-Hodgkin Lymphoma or TB pericarditis)

 

Pham TV. Human Immunodeficiency Virus Infection–Related Heart Disease. Emergency medicine clinics of North America. 2015-08;33:613-622.