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Review
. 2022 Sep 1;17(5):270-278.
doi: 10.1097/COH.0000000000000756. Epub 2022 Jul 5.

Cardiovascular disease risk in women living with HIV

Katherine Kentoffio  1 , Tecla M Temu  2 , Saate S Shakil  3 , Markella V Zanni  4 , Chris T Longenecker  2   3
Affiliations
Review

Cardiovascular disease risk in women living with HIV

Katherine Kentoffio et al. Curr Opin HIV AIDS. .

Abstract

Purpose of review: To synthesize current evidence on the impact of cardiovascular disease among women living with HIV (WLWH) with a particular focus on disease prevalence, mechanisms and prevention.

Recent findings: HIV-related cardiovascular disease risk is 1.5-fold to 2-fold higher for women than for men. Mechanisms of enhanced risk are multifactorial and include reinforcing pathways between traditional risk factors, metabolic dysregulation, early reproductive aging and chronic immune activation. These pathways influence both the presentation of overt syndromes of myocardial infarction, stroke and heart failure, as well as subclinical disease, such as microvascular dysfunction and cardiac fibrosis. Cardiovascular disease, therefore, remains a consistent threat to healthy aging among WLWH.

Summary: Although no specific prevention strategies exist, patient-centered risk mitigation approaches that are adaptable to the needs of aging individuals are essential to combat disparities in cardiovascular outcomes among WLWH. Further research into the optimal prevention approach for CVD among WLWH, particularly for women living in under-resourced health systems, is needed.

Trial registration: ClinicalTrials.gov NCT02272946.

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Figures

Figure 1:
Figure 1:. Sex-stratified HIV-associated risks of myocardial infarction, stroke, and heart failure from epidemiologic studies.
Relative risk of adverse cardiovascular outcomes stratified by sex as published in large-scale epidemiologic studies. Men living with HIV as compared to men without HIV infection are represented in the green bars, women living with HIV as compared to women without HIV infection are represented in purple bars.
Figure 2:
Figure 2:. Intersecting Risk Pathways for Cardiovascular Disease Among Women Living with HIV
Women living with HIV have two axes on which cardiovascular risk is built – risk according to sex and risk according to HIV serostatus. Along these two axes, specific risk categories intersect to inform the overt presentation of cardiovascular disease. Abbreviations: cART = combination antiretroviral therapy.
See this image and copyright information in PMC

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References

    1. Currier JS, Taylor A, Boyd F, Dezii CM, Kawabata H, Burtcel B, et al. Coronary Heart Disease in HIV-Infected Individuals: JAIDS J Acquir Immune Defic Syndr. 2003. Aug;33(4):506–12. - PubMed
    1. Tabib A, Leroux C, Mornex JF, Loire R. Accelerated coronary atherosclerosis and arteriosclerosis in young human-immunodeficiency-virus-positive patients. Coron Artery Dis. 2000. Feb;11(1):41–6. - PubMed
    1. Freiberg MS, Chang CCH, Kuller LH, Skanderson M, Lowy E, Kraemer KL, et al. HIV Infection and the Risk of Acute Myocardial Infarction. JAMA Intern Med. 2013. Apr 22;173(8):614. - PMC - PubMed
    1. Phillips AN, Carr A, Neuhaus J, Visnegarwala F, Prineas R, Burman WJ, et al. Interruption of antiretroviral therapy and risk of cardiovascular disease in persons with HIV-1 infection: exploratory analyses from the SMART trial. Antivir Ther. 2008;13(2):177–87. - PubMed
    1. Hunt PW, Lee SA, Siedner MJ. Immunologic Biomarkers, Morbidity, and Mortality in Treated HIV Infection. J Infect Dis. 2016. Oct 1;214 Suppl 2:S44–50. - PMC - PubMed

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