Coronary Artery Disease in People Living with Human Immunodeficiency Virus

People living with HIV live longer now due to highly active antiretroviral therapy. Due to their increased life expectancy, they have an increased cardiovascular risk cause by the traditional risk factors (smoking, use of ilicit drugs, obesity/lipodystrophy, dyslipidemia, diabetes, hypertension) and particular risk factors (endothelial dysfunction, inflammation, coagulation abnormalities, viral coinfections and antiretroviral therapy. The pathophysiology of accelerated atherosclerosis is complex. Coronary artery disease become an important cause of mortality in these patients. The incidence of coronary artery disease and especially of acute myocardial infarction is generally low among HIV patients, but it may by twice as high as in patients with the similar characteristics. Medical treatment for coronary disease in these patients has no special particularities comparing to general population, but possible drug interactions must be considered. Indication for coronary revascularization, either angioplasty, or aorto-coronary by-pass follows general indications for general population.