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Cardiovascular Disease in HIV Patients:
An Emerging Paradigm and Call to Action
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Reported by Jules Levin
CROI 2015 Feb 23-26, Seattle, WA
Steven Grinspoon, M.D.
Professor of Medicine
Harvard Medical School
webcast:
http://www.croiwebcasts.org/console/player/25786?mediaType=podiumVideo&
from Jules: a key story & message at CROi this year is the risk for sub-clinical heart disease, although this is not a new story since Dr Grinspoon and his group at Mass General have been reporting on this for several years including with publications, this talk includes an update with new information. The increased risk for heart disease among HIV+ is not a new development as researchers & the NIH have been paying attention to this for several years. Of note this problem highlighted by Dr Grinspoon is particularly concerning because the disease is "subclinical" meaning these cardiovascular abnormalities are not detectable by normal lab testing, are below the surface, "subclinical". I will send you a series of 3 oral talks all from the group at Mass General related to heart disease in HIV+. This is a compelling problem in HIV as HIV+ individuals, both men & women are facing increased heart disease risks compared to HIV-negs and is particularly of concern with HIV aging patients. At CROI other complications also recd attention including bone disease, cancers, brain & neurologic disease, and renal disease, and again with aging patients these diseases are of increasing risk to patients. The WIHS study reported increased risk for fractures in HIV+ women vs HIV-neg women, I sent out this report yesterday. The NCI reported "sizeable absolute" increased cancer risks in HIV+ vs HIV-neg, I sent out this report (CROI: NCI sees "sizeable absolute risk" of cancer in elderly with HIV). Of note there are 2 exercise studies at CROI that show improved heart disease risk factors & improved brain volume & brain biomarkers for HIV+.
You will see in the slides Dr Grinspoon highlights heightened immune activation in HIV+ and an increased risk for non-calcified and "high-risk" morphology plaque that is more prone to rupture. A large randomized statin study in HIV is beginning looking at heart disease & other comorbidity outcomes.
Cardiovascular Disease in HIV Patients: An Emerging Paradigm and Call to Action
Reported by Jules Levin
CROI 2015 Feb 23-26, Seattle, WA
Steven Grinspoon, M.D.
Professor of Medicine
Harvard Medical School
webcast:
http://www.croiwebcasts.org/console/player/25786?mediaType=podiumVideo&
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