Since the introduction of Antiretroviral Therapy (ART), the health prospect for the HIV-infected population has evolved considerably. The application of ART has led to a significant reduction in the rate of mortality for this group of people (Chastain et al., 2015). However, the number of deaths resulting from non-HIV-related diseases including cardiovascular diseases (CVD), hepatic disease, and cancer has taken the opposite turn. This paper evaluates the association between CVD and the administration of ART among HIV patients. A study in this area may be helpful in reducing the occurrence of CVD in the HIV-infected population. A prompt detection and treatment of such diseases are vital to reducing the mortality rates for individuals in this group substantially.
According to a study by Chastain et al. (2015), the prevalence of CVD associated with exposure will keep on rising with the decrease in mortality rate for HIV-infected patients. The use of potent and effective ART to control HIV-RNA viremia has resulted in a considerable decline in the occurrence of most CVDs except coronary artery disease (CAD). Kaplan et al. (2016) hold that HIV-infected patients collectively have a higher occurrence of CVD as compared to those who are not infected with HIV. Moreover, even after controlling the CVD risk factors that are typical of HIV-infected individuals, this group tends to possess a higher likelihood of suffering from CVDs.
The findings by Chastain et al. (2015) imply that since ART seems to be useful on serum lipid profiles, future research should be aimed at developing interventions for reducing the danger of CVD associated with HIV. Some effective interventions include smoking cessation, change in lifestyle, and pharmacotherapy. Further, a regular switching of antiretroviral regimens may bring about an improvement in lipid profiles and glucose metabolism; nonetheless, care should be taken because of a possible danger of virologic failure. On the other hand, Kaplan et al. (2016) argue that while the pointers of a weak HIV control program such as high HIV-RNA and a low CD4+ T-cell count are often associated with patients having the greatest danger of suffering CVD, a properly-controlled ART may also pose a significant risk of getting CVD. Further, individuals with an advanced HIV infection may be susceptible to steatosis and cardiac fibrosis.
Findings by DAD Study Group (2007) imply that the impact of ART varies depending on drug class. There is a relationship between exposure to protease inhibitors and the danger of getting a myocardial infarction. However, there is no evident relationship between non-nucleoside reverse-transcriptase inhibitors and the likelihood of getting CVD. Towards the end of their study, this group inferred that the impact of protease inhibitors in the study may have been partially a result of the effects of such agents on serum lipid profiles.
Chastain et al. (2015) suggest the use of medications frequently used in the general population to counter the occurrence of CVD. These drugs tend to lower the amount of lipids in the body and may include fibrates, statins, and cholesterol absorption inhibitors. To aid in glucose metabolism, HIV-infected patients may take anti-diabetic medications including sulfonylureas, metformin, thiazolidinediones, DPP-IV inhibitors and GLP-1 agonists. Care should be taken when inducing extra medication because there is a potential danger of adverse reactions to the ART medication. Negative ART-drug interactions may lead to rhabdomyolysis, myalgias or hypoglycemia (Chastain et al., 2015).
References
Chastain, D. B., Henderson, H., & Stover, K. R. (2015). Epidemiology and management of antiretroviral-associated cardiovascular disease. The open AIDS journal, 9, 23.
Kaplan, R. C., Hanna, D. B., & Kizer, J. R. (2016). Recent Insights into Cardiovascular Disease (CVD) Risk Among HIV-Infected Adults. Current HIV/AIDS Reports, 13(1), 44-52.
The DAD Study Group. (2007). Class of Antiretroviral Drugs and the Risk of Myocardial Infarction. The New England Journal of Medicine, 356;17.
