Antiretroviral therapy use is associated with ectopic pericardial and paracardiac adipose deposition in people living with HIV

Cardiovascular disease (CVD) is a major contributor to morbidity and mortality in people living with human immunodeficiency virus (PLHIV). In the general population, increased pericardiac adipose tissue is associated with poor cardiovascular outcomes, but its role in HIV-associated CVD is not well described. Using cardiovascular magnetic resonance (CMR), we report increased pericardial adipose tissue (PAT) and paracardiac adipose tissue (ParaAT) in PLHIV on ART compared to uninfected controls, with untreated PLHIV having an intermediate phenotype. For PLHIV not on ART, myocardial inflammation is associated with more significant impairment in strain and tissue characteristics, but not PAT and ParaAT volume.