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Cardiovascular Disease in HIV Patients: An Emerging Paradigm and Call to Action


Jeffrey Pope
Monday, March 2, 2015

Jeffrey Pope is an advocate, community educator, and pro bono consultant for MAACA, Inc. living in Tallahassee, Florida and attended CROI in association with the AVAC/Black AIDS Institute initiative.

At CROI 2015 we heard a lot about intermittent use of PrEP, PrEP on demand and vaginal microbicides. However, there is still the issue of HIV and cardiovascular disease which has been with us for decades and still the need for research.

It should be noted that there was an early association of antiretroviral therapy with cardiovascular disease. However, in a presentation by Steven Grinspoon, Cardiovascular Disease in HIV Patients: An Emerging Paradigm and Call to Action, he argued that perhaps there are beneficial aspects on cardiovascular disease related to antiretroviral therapy that must be comingled and adjusted according to the end effects.

The researcher presented current challenges in preventing, treating and identifying patients with HIV related CVD:

Understanding and timing of the use of antiretroviral therapies to maximize effects on immune function and minimize metabolic effects.

Developing safe and effective strategies for primary prevention of cardiovascular disease while still at subclinical levels.

Developing interventions that address both traditional and immune related risk.

Developing successful strategies for lower income countries with burgeoning and intersection in epidemics of HIV and cardiovascular disease.

Potential Intervention in Cardiovascular Disease:


Anti-hypertensive, anti-diabetic, anti-smoking, lipid lowering.

Immune inflammatory modulators:

CCR five antagonists, IL antagonists, methotrexate, et. al.

Conclusions and Future Directions

Traditional and nontraditional risk factors contribute to cardiovascular disease risk in HIV.

Modulation of traditional and nontraditional risk is necessary to prevent cardiovascular disease in HIV.

While we have learned much regarding the unique pathophysiology and characteristics of plaque formation and HIV, significant challenges remain including identifying high-risk patients and developing effective prevention strategies.

With special thanks to AVAC, Black AIDS Institute, the CROI Welcoming Committee and MAACA, Inc. without whose support I could not have attended this most informative of all HIV/AIDS conferences.