Pathogenesis of HIV-Associated Cardiomyopathy
Reviews and studies published before the introduction of highly active antiretroviral therapy (HAART) regimens have tracked the incidence and course of human immunodeficiency virus (HIV) infection in relation to cardiac illness in both children and adults. HAART regimens have significantly modified the course of HIV disease, with longer survival rates and improvement of life quality in HIV+ subjects expected. However, early data raised concerns about HAART's being associated with an increase in both peripheral and coronary arterial diseases. A variety of potential etiologies have been postulated in HIV-related heart disease, including myocardial infection with HIV itself, opportunistic infections, viral infections, autoimmune response to viral infection, drug-related cardiotoxicity, nutritional deficiencies, and prolonged immunosuppression. In this review article we discuss HIV-associated cardiovascular complications, focusing on pathogenetic mechanisms that may play a role in diagnosis, management, and therapy of these complications.
pathogenesis hiv hiv-associated cardiomyopathy autoimmunity immunopathogenesis myocarditis viral myocardial infection coxsackievirus cytomegalovirus epstein-barr virus adenovirus chemokines cytokines hiv-associated pulmonary hypertension nutritional disorders drug cardiotoxicity risk groups