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Review
. 2024 May 24;134(11):e150-e175.
doi: 10.1161/CIRCRESAHA.124.323979. Epub 2024 May 23.

HIV-Associated Hypertension: Risks, Mechanisms, and Knowledge Gaps

Prem Prakash  1   2   3 , Berwin Singh Swami Vetha  4 , Rajasree Chakraborty  1   2   3 , Tara-Yesomi Wenegieme  5 , Sepiso K Masenga  6 , Gladson Muthian  1   2   3 , Muthukumar Balasubramaniam  1   2   3 , Celestine N Wanjalla  7 , Antentor O Hinton Jr  8 , Annet Kirabo  7   9   10   11 , Clintoria R Williams  5 , Azeez Aileru  4 , Chandravanu Dash  1   2   3
Affiliations
Review

HIV-Associated Hypertension: Risks, Mechanisms, and Knowledge Gaps

Prem Prakash et al. Circ Res. .

Abstract

HIV type 1 (HIV-1) is the causative agent of AIDS. Since the start of the epidemic, HIV/AIDS has been responsible for ≈40 million deaths. Additionally, an estimated 39 million people are currently infected with the virus. HIV-1 primarily infects immune cells, such as CD4+ (cluster of differentiation 4+) T lymphocytes (T cells), and as a consequence, the number of CD4+ T cells progressively declines in people living with HIV. Within a span of ≈10 years, HIV-1 infection leads to the systemic failure of the immune system and progression to AIDS. Fortunately, potent antiviral therapy effectively controls HIV-1 infection and prevents AIDS-related deaths. The efficacy of the current antiviral therapy regimens has transformed the outcome of HIV/AIDS from a death sentence to a chronic disease with a prolonged lifespan of people living with HIV. However, antiviral therapy is not curative, is challenged by virus resistance, can be toxic, and, most importantly, requires lifelong adherence. Furthermore, the improved lifespan has resulted in an increased incidence of non-AIDS-related morbidities in people living with HIV including cardiovascular diseases, renal disease, liver disease, bone disease, cancer, and neurological conditions. In this review, we summarize the current state of knowledge of the cardiovascular comorbidities associated with HIV-1 infection, with a particular focus on hypertension. We also discuss the potential mechanisms known to drive HIV-1-associated hypertension and the knowledge gaps in our understanding of this comorbid condition. Finally, we suggest several directions of future research to better understand the factors, pathways, and mechanisms underlying HIV-1-associated hypertension in the post-antiviral therapy era.

Keywords: cardiovascular diseases; cytopathogenic effect, viral; noncommunicable diseases; quality of life; sodium chloride, dietary.

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Conflict of interest statement

Disclosures None.

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  • HIV and Cardiovascular Disease.
    Afolabi JM, Kirabo A. Afolabi JM, et al. Circ Res. 2024 May 24;134(11):1512-1514. doi: 10.1161/CIRCRESAHA.124.324805. Epub 2024 May 23. Circ Res. 2024. PMID: 38781297 Review. No abstract available.

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