Cardiovascular Disease in AIDS by G. Di Perri, S. Audagnotto, F. Gobbi, L. Trentini (auth.),

By G. Di Perri, S. Audagnotto, F. Gobbi, L. Trentini (auth.), Giuseppe Barbaro, Franck Boccara (eds.)

The creation of hugely energetic antiretroviral treatment (HAART) has considerably superior the medical final result of HIV ailment with elevated survival charges. notwithstanding, the creation of HAART has generated a distinction within the cardiac manifestations of AIDS. In constructed nations, we saw an approximate 30% aid within the incidence of HIV-associated cardiomyopathy, in all probability concerning a discount of opportunistic infections and myocarditis. In constructing international locations, in spite of the fact that, the place the supply of HAART is proscribed and the pathogenic effect of dietary components is critical, we saw an approximate 32% raise within the occurrence of HIV-associated cardiomyopathy and a similar excessive mortality expense from congestive middle failure. also, a few HAART regimens in built nations, specially these together with protease inhibitors, can cause an iatrogenic metabolic syndrome (HIV-lipodystrophy syndrome) that's linked to an elevated danger of heart problems. whilst, the relapse of a few opportunistic infections, with attainable myocardial involvement, in HIV-infected sufferers receiving HAART, within the context of the lately defined immune reconstitution inflammatory syndrome, yielded an exciting and intricate profile of this twin element of cardiology in AIDS within the HAART period. during this new version of heart problems in AIDS, new insights coming from easy and medical study within the box of HIV-associated heart problems and antiretroviral treatment are pronounced, in addition to the scientific directions for a cautious stratification of the cardiovascular possibility and cardiovascular tracking of HIV-infected sufferers receiving HAART. The authors provide a large review of the subject for experts in cardiology and infectious illnesses interested in the scientific administration of HIV-infected patients.

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2 Adipocytes secrete a range of adipocytokines which control insulin sensitivity level to reduce food intake and to regulate energy production and utilization. In addition, leptin exerts pleiotropic actions and plays a role in peripheral energy and bone metabolism, reproduction, and immunity. Leptin receptors located on muscle cells have been shown to activate AMP kinase (AMPK) and thereby to favor FFA oxidation (see the following section). Adiponectin Adiponectin or adipoQ or ACRP30 is secreted at high levels by adipose tissue, and circulating levels are between 5 and 10 μg/ml in human plasma.

6). Because the reservoir cells are not affected by treatment, the effect is independent of whether the patient receives HAART. Nutritional Deficiencies as a Factor in Left Ventricular Dysfunction Nutritional deficiencies are common in HIV infection and may contribute to ventricular dysfunction independently of HAART. Malabsorption and diarrhea can both lead to trace-element deficiencies which have been directly or indirectly associated with cardiomyopathy [34–36]. Selenium replacement may reverse cardiomyopathy and restore left ventricular function in selenium-deficient patients [34–36].

7. 8. 9. 10. Barbaro G, Di Lorenzo G, Grisorio B, Barbarini G and the Gruppo Italiano per lo Studio Cardiologico dei pazienti affetti da AIDS Investigators (1998) Cardiac involvement in the acquired immunodeficiency syndrome: a multicenter clinical-pathological study. AIDS Res Hum Retroviruses 14:1071–1077 Temesgen Z (1999) Overview of HIV infection. Ann Allergy Asthma Immunol 83:1–5 Barbaro G (2002) Cardiovascular manifestations of HIV infection. Circulation 106:1420–1425 Barbarini G, Barbaro G (2003) Incidence of the involvement of the cardiovascular system in HIV infection.

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