Cardiovascular Disease Imaging in HIV

Because of the success of new, potent antiretroviral therapy, life expectancy has significantly improved among HIV-infected patients. However, an opposite trend has been noted for cardiovascular disease (CVD) among patients with HIV. Cardiovascular morbidity and mortality have increased since 1999, and CVD has become a significant public health issue among HIV-infected patients in whom rates of myocardial infarction and stroke may be up to twice as high as compared with similarly age-matched patients in the general population. Although HIV-infected patients may exhibit increases in specific CVD risks, including excess smoking rates, higher rates of insulin resistance and diabetes mellitus, and dyslipidemia, carefully controlled studies demonstrate that the excess rates of CVD persist after controlling for traditional risks. One important question for the HIV community is whether statins work to improve CVD rates and whether traditional algorithms designed for the non-HIV population can be used to identify those patients with HIV who might benefit from statin therapy.