TreatmentUpdate
217

September/October 2016 

Dealing with heart- and age-related issues

Chronic HIV infection activates and inflames the immune system. Taking combination anti-HIV therapy (ART) every day and achieving and maintaining an undetectable viral load greatly help to reduce immune activation and inflammation. As a result, ART users in Canada and other countries are living longer, some into their 60s, 70s and into their 80s.

However, ART cannot cure chronic HIV infection; even with these medications, the virus continues to cause low-level infection in lymph nodes and lymphatic tissues. In those parts of the body, ongoing production of HIV and its proteins causes cells of the immune system to become activated and low-level inflammation ensues. These activated cells of the immune system also travel to other organ-systems, perhaps spreading inflammatory signals and affecting the health of these other organ-systems.

The heart and its blood vessels are called the cardiovascular system. Reports presented in this issue of TreatmentUpdate suggest that the cardiovascular system is particularly affected by HIV. As HIV-positive people age, staying in general good health and maintaining the health of the cardiovascular system becomes particularly important. Whatever is good for the heart is good for the brain and body. A great place to begin to learn about maintaining or improving heart health is CATIE’s newly revised fact sheet HIV and Cardiovascular Disease. It has useful tips and links for information about support for quitting smoking, changes to the diet, incorporating exercise into your life and, if necessary, options about medical interventions.

In this issue of TreatmentUpdate we review studies on issues related to aging, survival and cardiovascular disease.

Resource:

HIV and cardiovascular disease – CATIE fact sheet

—Sean R. Hosein

REFERENCES:

  1. Panigrahi S, Freeman ML, Funderburg NT, et al. SIV/SHIV infection triggers vascular inflammation, diminished expression of Krüppel-like factor 2 and endothelial dysfunction. Journal of Infectious Diseases. 2016 May 1;213(9):1419-27.
  2. Helleberg M, May MT, Ingle SM, et al. Smoking and life expectancy among HIV-infected individuals on antiretroviral therapy in Europe and North America. AIDS. 2015 Jan 14;29(2):221-9.
  3. Lorenzo-Redondo R, Fryer HR, Bedford T, et al. Persistent HIV-1 replication maintains the tissue reservoir during therapy. Nature. 2016 Feb 4;530(7588):51-6.
  4. Fletcher CV, Staskus K, Wietgrefe SW, et al. Persistent HIV-1 replication is associated with lower antiretroviral drug concentrations in lymphatic tissues. Proceedings of the National Academy of Sciences USA. 2014 Feb 11;111(6):2307-12.