chapter  20
12 Pages

HIV- and Cocaine-Induced Subclinical Atherosclerosis

WithShenghan Lai, Qingyi Meng, João A. C. Lima

The acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV-1 or HIV). The primary targets of these infections include the lungs, skin, gastrointestinal tract, and central nervous system. Cardiac involvement was thought to be rare during the early years of the HIV epidemic. In recent years, however, a growing body of evidence has accumulated indicating that cardiac dysfunction can occur in persons infected with HIV. Among the complications associated with HIV disease are pericarditis, myocarditis, ventricular tachycardia, endocarditis, metastatic involvement from Kaposi’s sarcoma, and dilated cardiomyopathy (1). As antiretroviral treatment has improved and prevention of opportunistic infections has become more effective, cardiac disease has emerged as an important component of AIDS. Early data from those treated with highly active antiretroviral therapy (HAART) have raised concerns about a possible increase in both vascular and coronary heart disease (2-4). Some patients receiving protease inhibitors (PIs), key components of HAART, develop various forms of risk factors for coronary artery disease (CAD), such as hyperlipidemia, hyperglycemia, central obesity, and endothelial dysfunction (5,6).