Key result
People living with HIV have an increased prevalence of cardiac steatosis, which may act as a mediator for the elevated risk of cardiovascular disease and heart failure observed in this population.
Cardiac steatosis in HIV patients is associated with metabolic and inflammatory changes, and targeting these pathways may improve cardiovascular outcomes in this population.
Cardiac steatosis may mediate excess CVD/HF risk in HIV; hypothesis-generating, needs prospective validation before practice change.
Although people living with HIV (PLHIV) are approaching normal life expectancy, a limitation to achieving this goal is managing the higher prevalence of co-morbidities, including cardiovascular disease. Whilst ischaemic heart disease likely contributes to a large proportion of cardiac disease in the modern era of treatment, cardio-metabolic disease, including cardiac steatosis, akin to obesity-related heart disease, is also a possible mechanism of increased cardiac morbidity and mortality. HIV and other metabolic and inflammatory diseases affecting the heart, including obesity, share many cardio-metabolic abnormalities, with increased pericardial and myocardial fat content, in association with chronic systemic inflammatory changes and alterations in cardiac metabolism. Understanding the mechanisms of HIV-associated cardiac steatosis remains an important challenge, as managing the untreated metabolic and inflammatory precipitants may substantially improve cardiac outcomes for PLHIV.
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Jacob et al. (2018) conducted a review in HIV and Cardiac Steatosis. HIV infection and antiretroviral therapy was evaluated. People living with HIV have an increased prevalence of cardiac steatosis, which may act as a mediator for the elevated risk of cardiovascular disease and heart failure observed in this population.
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