L.V. PUZYRYOVA¹, Z.M. ALIMBETOV¹, M.V. BALABOKHINA², M.A. PRIVALOVA³

 ¹Omsk State Medical University, Omsk

²Center for the Prevention and Control of AIDS and Infectious Diseases of the Omsk Region, Omsk

³City Clinical Emergency Hospital No. 2, Omsk

Contact details:

Puzyreva L.V. — MD, Associate Professor, Head of the Department of Pediatric Infectious Diseases

Address: 2 Lenin St., 644099 Omsk, Russian Federation, tel.: +7-913-149-1232, e-mail: puzirevalv@mail.ru

Vascular atherosclerosis in patients with HIV infection develops faster and more often than in HIV-negative patients, even despite modern antiretroviral therapy.

The purpose — to evaluate the effect of specific and non-specific factors on the development of atherosclerosis and cardiovascular diseases in HIV patients, analyzing the data of previous studies.

Material and methods. We reviewed the Russian and foreign studies of 2013–2026 devoted to atherosclerosis in HIV patients. Data from clinical observations and meta-analyses in infected and uninfected patients were analyzed.

Results. Atherosclerosis in HIV patients is considered a multifactorial polyetiological process involving traditional and specific risk factors. The central pathogenetic factor is chronic immune activation supporting systemic endothelial inflammation. In addition, patients with HIV infection almost always have dyslipidemia and an increased blood clotting.

In HIV-positive people, signs of subclinical atherosclerosis and instability of coronary atherosclerotic plaques are detected more often, and acute coronary syndrome can manifest at a younger age.

On the one hand, antiretroviral therapy prolongs the patient’s life; on the other hand, it increases the risk of heart and vascular diseases. Active use of drugs does not reduce the degree of chronic inflammation in the body, which leads to accelerated atherogenesis. The adverse effects of some groups of antiretroviral therapy on the lipid metabolism of HIV patients are well-known. In this regard, HIV infection is considered an independent predictor of cardiovascular disease, which requires early diagnosis, dynamic observation and active prevention of cardiovascular complications.

Key words: overview, HIV infection, cardiovascular disease, risk factors, cardiotoxicity, antiretroviral therapy, adherence

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