Principal HIV/AIDS-associated cardiovascular abnormalities

1.Type. Dilated cardiomyopathy.

Possible etiologies and associations:
HIV/AIDS, Toxoplasma gondii, Coxsackievirus group B,Epstein-Barr virus, Cytomegalovirus, Adenovirus
Autoimmune response to infection
Drug-related
Cocaine, possibly nucleoside analogs
IL-2, doxorubicin, interferon
Metabolic/endocrine
Nutritional deficiency/wasting
Selenium, B12, carnitine
Thyroid hormone, growth hormone
Adrenal insufficiency, hyperinsulinemia
Cytokines
TNF-, nitric oxide, TGF-, endothelin-1
Hypothermia
Hyperthermia
Autonomic insufficiency
Encephalopathy
Acquired immunodeficiency
HIV/AIDS viral load, length of immunosuppression

Incidence:
15.9 patients/1,000 asymptomatic
HIV/AIDS- infected persons before the introduction of HAART

2 Type. Coronary heart disease.

Possible etiologies and associations:
Protease-inhibitor-induced metabolic and coagulative disorders. Arteritis

Incidence:
Studies on the risk of coronary heart
disease among HIV/AIDS-infected individuals receiving protease inhibitor including HAART have not shown a consistent association


3Type. Systemic arterial hypertension.

Possible etiologies and associations:
HIV/AIDS-induced endothelial dysfunction.
Vasculitis in small, medium, and large vessels in the form of leukocytoclastic vasculitis; atherosclerosis secondaryto HAART;
aneurysms of the large vessels such as the carotid, femoral, and abdominal aorta with impairment of flow to the renal arteries; PI-induced insulin resistance with increased sympathetic activity and sodium retention

Incidence:
20%–25% of HIV-infected persons before the introduction of HAART Up to 74% in HIV/AIDS-infected persons with HAART-related metabolic syndrome


4Type. Pericardial effusion.

Possible etiologies and associations:

Bacteria: Staphylococcus, Streptococcus, Proteus,Nocardia, Pseudomonas, Klebsiella Enterococcus, Listeria, Mycobacteria (Mycobacterium tuberculosis, Mycobacterium avium intracellulare, Mycobacterium kansaii)
Viral pathogens
HIV, herpes simplex virus, herpes simplex
virus type 2, cytomegalovirus
Other pathogens
Cryptococcus, Toxoplasma, Histoplasma
Malignancy
Kaposi’s sarcoma
Malignant lymphoma
Capillary leak/wasting/malnutrition
Hypothyroidism
Prolonged acquired immunodeficiency

Incidence:
11%/year in asymptomatic AIDS patients before the introduction of HAART