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AIDS and Heart Disease

2004 Edition, June 22, 2004

Complete Document



Detail Summary

Active, Most Current

EN
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ISBN: 978-0-8247-4115-0
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Product Details:

  • Revision: 2004 Edition, June 22, 2004
  • Published Date: June 22, 2004
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 446
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:

Preface

Although heart disease should not be a problem among AIDS patients, since most are children or relatively young adults, more than 50% have significant signs of cardiac damage upon autopsy. As antiretroviral drugs prolong their survival, the importance and prevalence of heart disease in AIDS patients will only increase as they age and enter the time in life when heart disease is frequent. Even so, dilated cardiomyopathy and associated symptoms of congestive heart failure are being recognized with increasing frequency in retrovirus-infected people. Estimates are that 25% of HIV-seropositive individuals will eventually manifest evidence of left ventricular dysfunction, giving rise to as many as 50,000 new cases of symptomatic heart failure each year among these patients. Despite this clinical recognition, the pathogenesis of AIDS-related cardiomyopathy remains unclear, limiting application of both specific treatments and preventive strategies. This book defines, in several chapters, the role of retroviruses in heart disease occurring in murine, primate, and human systems. Limitations in the understanding of the relationship between HIV infection and the development of dilated cardiomyopathy are confounded by the use of illicit drugs and antiretroviral agents, which may be cardiotoxic. Therefore we emphasize the role of drug abuse and alcohol as immunodulatory substances that have a role in AIDS-related heart disease. The current therapeutic drugs, protein inhibitors, promote the accumulation of fat and longer survival, increasing the contributory factors and allowing more time for the development of damage to the heart. Very recent work shows that retroviruses cause direct heart damage as well as weakening of the immune system, so that opportunistic pathogens can take hold, persist, and eventually damage the heart. Accumulation of fat and dramatically increased levels of serum fatty acids and cholesterol—as often happens during protease inhibitor treatment of AIDS—are well-known risk factors for cardiovascular disease. Improved nutrition remains a mild and readily available approach to modifying these changes and their actions on heart function during retroviral infection. A number of chapters describe the roles of fat, antioxidants, and other nutritional and dietary materials that can modify or affect heart disease. The potential synergisms with the modifications made by the retroviral infection are defined.

This book provides vital, up-to-date reviews of the mechanisms by which HIV infects target cells (endothelial cells), damages the heart and related vascular systems, and facilitates the destructive effects of other pathogens. In addition, the cardiotoxic side effects of current AIDS therapies, such as changes in body fat, need to be explained and ideas for their mediation must be carefully reviewed. This book, then, will serve as a desk reference for AIDS and cardiovascular researchers as well as primary care physicians and AIDS patients themselves. It will stimulate research while educating both health-oriented lay people as well as scientists and health care professionals.