Heart disease in HIV infection

Anthony Dart

Alfred Hospital and Baker Medical Research Institute, Melbourne.

Last reviewed: November 2019

Introduction

The arrival of effective antiretroviral therapy (ART) has meant that there are many HIV-infected people living to advanced age. Therefore, diseases more associated with the middle and older years will achieve increasing importance as co-morbidities of HIV infection. In the time before effective ART there were a number of cardiac/vascular conditions more commonly seen in HIV-infected patients than in uninfected patients from similar backgrounds; these included dilated cardiomyopathy, pulmonary hypertension and pericardial effusions. Happily, these are seen less frequently since the arrival of effective ART. Nonetheless, these diagnoses are important to consider in patients with appropriate physical signs. Arrhythmias occur often in the in the setting of cardiovascular disease (CVD) and should be assessed and treated accordingly. Additionally, cardiac electrical dysfunction may be precipitated by antiretroviral drugs and their interactions with other medications.