Cardiovascular disease and risk assessment in people living with HIV: Current practices and novel perspectives

Human immunodeficiency virus (HIV) infection represents a major cardiovascular risk factor, and the cumulative cardiovascular disease (CVD) burden among aging people living with HIV (PLWH) constitutes a leading cause of morbidity and mortality. To date, CVD risk assessment in PLWH remains challenging. Therefore, it is necessary to evaluate and stratify the cardiovascular risk in PLWH with appropriate screening and risk assessment tools and protocols to correctly identify which patients are at a higher risk for CVD and will benefit most from prevention measures and timely management. This review aims to accumulate the current evidence on the association between HIV infection and CVD, as well as the risk factors contributing to CVD in PLWH. Furthermore, considering the need for cardiovascular risk assessment in daily clinical practice, the purpose of this review is also to report the current practices and novel perspectives in cardiovascular risk assessment of PLWH and provide further insights into the development and implementation of appropriate CVD risk stratification and treatment strategies, particularly in countries with high HIV burden and limited resources. & COPY; 2023 Hellenic Society of Cardiology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

HIV infection is a major cardiovascular risk factor, and cardiovascular disease (CVD) burden is a leading cause of morbidity and mortality among people living with HIV (PLWH). It is necessary to evaluate and stratify cardiovascular risk in PLWH to identify higher risk patients who will benefit most from prevention measures and timely management. This review aims to accumulate evidence on the association between HIV infection and CVD, as well as risk factors contributing to CVD in PLWH. It also focuses on current practices and novel perspectives in cardiovascular risk assessment of PLWH and provides insights into appropriate CVD risk stratification and treatment strategies, especially in countries with high HIV burden and limited resources.