Cor Vasa 2022, 64(3):291-299 | DOI: 10.33678/cor.2021.132

The power and wisdom of prevention. Cardiovascular risk, new challenge, and approach to PLWH

Ricardo Massmann^a, David Jilich^b, Lukáš Fleischhans^b, Marek Malý^c, Ladislav Machala^d

^a Department of Infectious and Tropical Diseases, Third Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague

^b Department of Infectious and Tropical Diseases, First Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague

^c Department of Biostatistics, National Institute of Public Health, Prague

^d Department of Infectious Diseases, Third Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague and HIV/AIDS Center - Department of Infectious Diseases, Bulovka University Hospital, Prague

In recent years, quality of life is one of the important points of discussion among specialists working with people living with HIV (PLWH). With the introduction of highly effective antiretroviral therapy (1996), the expectation of life has dramatically increased and atherosclerotic diseases have become an important cause of morbidity and mortality in people infected with human immunodeficiency virus (HIV). Cardiovascular diseases are the third leading cause of mortality in HIV patients behind non-AIDS-related malignancies and non-AIDS-related infection. One of the many aspects in the treatment of PLWH concerns the prevention of cardiovascular diseases. The absolute risk of developing major cardiovascular disease events (CVD), for example, sudden cardiac death, cardiac arrest, and stroke in HIV-infected patients receiving antiretroviral therapy is still low. However, this risk is increased compared to the risk of uninfected people. This fact is substantially due to a higher prevalence of traditional cardiovascular risk factors that are mostly dependent on the host. Different types of antiretroviral treatment impact differently on metabolic effects and CVD. Prevention of cardiovascular disease in HIV-infected patients is an important goal for a better quality of life. Traditional risk factors should be detected and treated vigorously when possible, to avoid the development of major adverse cardiovascular events (MACE).

Keywords: Antiretroviral therapy, Atherosclerosis, Cardiovascular disease, Human immunodeficiency virus

Received: September 21, 2021; Revised: October 31, 2021; Accepted: November 16, 2021; Published: June 22, 2022  Show citation