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HIV-Related Research in the Division of Cardiovascular Sciences (DCVS)

HIV-Focused Research Goals

Multiple studies have demonstrated that the risk of developing cardiovascular (CV) disease in HIV patients is significantly higher and may be accelerated compared to the general population. In addition, the pathophysiological mechanisms of HIV-related CV disease may be distinct because of the adverse effects of antiretroviral therapy (ART) and a greater contribution of inflammation, immune activation, microbial translocation, endothelial injury, and coagulation disorders. With the growing burden of HIV-related CV disease, NHLBI is uniquely poised to take a leadership role in supporting research that addresses the new phase of this epidemic.

The CV portfolio of the NHLBI AIDS Program falls within the Division of Cardiovascular Sciences (DCVS). The NHLBI AIDS Program supports basic, clinical, population, and health services research in HIV-related CV disease. Specific areas of interest include HIV-related atherosclerosis, heart failure, hypertension, stroke, arrhythmias, sudden cardiac death, and pulmonary hypertension.

Previously Funded Studies

In 2008, the NHLBI established the 5-year HIV CVD Collaborativeexternal disclaimer, which supports research on various aspects of HIV-related coronary artery disease (CAD) including cardio-metabolic risk factors, the role of biomarkers and imaging, the impact of different ART regimens on the development of CAD, and novel interventions to address the unique pathophysiology of this disease. Clinical studies are performed at 8 U.S. sites and managed by the Data Coordinating Center at the University of Washington.

Future Directions

Selected CV research examples of interest to the NHLBI AIDS Program include, but are not limited to, studies that:

  • Examine the incidence/prevalence of HIV-related, heart failure, and thrombotic complications
  • Use imaging to elucidate the pathogenesis of CAD in treated HIV patients
  • Assess the relative contribution of inflammation, ART, co-infections, and traditional risk factors on the development of CAD and arterial and venous thrombosis
  • Leverage existing databases/claims data/electronic health records to examine patterns of care/ variations/disparities in the prevention/diagnosis/treatment/outcomes of HIV-related CV disease
  • Assess the efficacy/effectiveness of evidence-based therapies for HIV-related CV disease
  • Assess appropriate targets for preventive/treatment therapies in HIV-related CV disease
  • Test novel therapies for HIV-related CV disease
  • Examine clinical features, patterns, and the natural history of HIV-related CAD, heart failure, pulmonary hypertension, and thrombotic complications
  • Test strategies to optimize therapy/prevention of HIV-related CV disease
  • Test strategies to optimize smoking cessation in the HIV population
  • Evaluate the incremental risk of smoking in HIV-related CV disease
  • Utilize pharmacogenomics to address drug toxicities of CV therapies in the HIV population

Selected Cardiovascular-Related Publications Supported by the NHLBI AIDS Program

  • Freiberg MS, Chang CC, Kuller LH, Skanderson M, Lowy E, Kraemer KL, Butt AA, Bidwell Goetz M, Leaf D, Oursler KA, Rimland D, Rodriguez Barradas M, Brown S, Gibert C, McGinnis K, Crothers K, Sico J, Crane H, Warner A, Gottlieb S, Gottdiener J, Tracy RP, Budoff M, Watson C, Armah KA, Doebler D, Bryant K, and Justice AC. HIV Infection and the Risk of Acute Myocardial Infarction. JAMA Intern Med. 2013; In-press.
  • Hsue PY, Scherzer R, Hunt PW, Schnell A, Bolger AF, Kalapus SC, Maka K, Martin JN, Ganz P, and Deeks SG. Carotid Intima-Media Thickness Progression in HIV-Infected Adults Occurs Preferentially at the Carotid Bifurcation and Is Predicted by Inflammation. J Am Heart Assoc. 2012; 1:jah3-e000422 doi: 10.1161/JAHA.111.000422.
  • Kelesidis T, Kendall MA, Yang OO, Hodis HN, Currier JS. Biomarkers of Microbial Translocation and Macrophage Activation: Association with Progression of Subclinical Atherosclerosis in HIV-1 Infection. J Infect Dis. 2012; 206(10): 1558-67.
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