Etiology and pathophysiology of heart failure in people with HIV. [Review]

MedStar author(s):
Citation: Heart Failure Reviews. 26(3):497-505, 2021 05.PMID: 33619685Institution: MedStar Union Memorial Hospital | MedStar Washington Hospital CenterDepartment: Internal Medicine ResidencyForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Cardiomyopathies | *Heart Failure | *HIV Infections | Antiretroviral Therapy, Highly Active | Disease Progression | Heart Failure/ep [Epidemiology] | Heart Failure/et [Etiology] | HIV Infections/co [Complications] | HIV Infections/dt [Drug Therapy] | HumansYear: 2021ISSN:
  • 1382-4147
Name of journal: Heart failure reviewsAbstract: 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.All authors: Bhoite R, Burkholder G, Choi H, Dey AK, Fedson S, Jneid H, Sharma GOriginally published: Heart Failure Reviews. 26(3):497-505, 2021 May.Fiscal year: FY2021Fiscal year of original publication: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2021-03-10
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Journal Article MedStar Authors Catalog Article 33619685 Available 33619685

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.

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