HIV-related comorbidities, including cardiovascular disease (CVD), have assumed a higher profile given the efficacy of antiretroviral therapy (ART). With the increased survival of persons living with HIV, several factors raise the risk for CVD, including the high rate of conventional CVD risk factors,1-8 the presence of HIV-related inflammatory and immunological processes,8,9 and metabolic dysregulations (eg dyslipidemia and insulin resistance) possibly associated with ART.10-12

Accordingly, CVD risk assessment has assumed a more prominent role in the management of HIV-infected persons, particularly those receiving ART. This assessment, however, needs to account for the distinctive factors affecting CVD risk in this population. The standard Framingham model for global CVD risk may not provide the most accurate assessment of the odds of cardiovascular events in HIV-infected persons. As a consequence, a modified predictive model derived from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study, which considers CD4 cell counts and administration of ART in addition to standard risk factors, has been developed (http://www.cphiv.dk/Tools) to alert clinicians to CVD risk in HIV-infected persons requiring more aggressive CVD risk-mitigation interventions.13 READ MORE

Comment