Centre for Cardio-metabolic Research in Africa, Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa.
Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Am J Physiol Heart Circ Physiol. 2020 Apr 1;318(4):H731-H746. doi: 10.1152/ajpheart.00549.2019. Epub 2020 Feb 21.
Although the extensive rollout of antiretroviral (ARV) therapy resulted in a longer life expectancy for people living with human immunodeficiency virus (PLHIV), such individuals display a relatively increased occurrence of cardiovascular diseases (CVD). This health challenge stimulated significant research interests in the field, leading to an improved understanding of both lifestyle-related risk factors and the underlying mechanisms of CVD onset in PLHIV. However, despite such progress, the precise role of various risk factors and mechanisms underlying the development of HIV-mediated CVD still remains relatively poorly understood. Therefore, we review CVD onset in PLHIV and focus on ) the spectrum of cardiovascular complications that typically manifest in such persons and ) underlying mechanisms that are implicated in this process. Here, the contributions of such factors and modulators and underlying mechanisms are considered in a holistic and integrative manner to generate a unifying hypothesis that includes identification of the core pathways mediating CVD onset. The review focuses on the sub-Saharan African context, as there are relatively high numbers of PLHIV residing within this region, indicating that the greater CVD risk will increasingly threaten the well-being and health of its citizens. It is our opinion that such an approach helps point the way for future research efforts to improve treatment strategies and/or lifestyle-related modifications for PLHIV.
尽管抗逆转录病毒 (ARV) 疗法的广泛推广使感染人类免疫缺陷病毒 (PLHIV) 的人的预期寿命延长，但此类人群发生心血管疾病 (CVD) 的相对几率增加。这一健康挑战激发了该领域的大量研究兴趣，使人们对 PLHIV 中与生活方式相关的风险因素和 CVD 发病的潜在机制有了更好的理解。然而，尽管取得了这些进展，HIV 介导的 CVD 发展中各种风险因素和机制的确切作用仍知之甚少。因此，我们回顾了 PLHIV 中的 CVD 发病情况，并重点关注)此类人群中常见的心血管并发症谱和)涉及该过程的潜在机制。在这里，我们以整体和综合的方式考虑这些因素和调节剂及其潜在机制的贡献，以生成一个统一的假说，包括确定介导 CVD 发病的核心途径。本综述侧重于撒哈拉以南非洲地区，因为该地区有相对较多的 PLHIV，这表明更高的 CVD 风险将日益威胁其公民的福祉和健康。我们认为，这种方法有助于为未来的研究工作指明方向，以改善 PLHIV 的治疗策略和/或与生活方式相关的改变。
