Peripheral Arterial Disease in Human Immunodeficiency Virus Infection.

PURPOSE OF REVIEW: Human immunodeficiency virus infection (HIV) is a chronic inflammatory and pro-atherosclerotic condition although the contribution of HIV to the development of peripheral arterial disease (PAD) is unclear. PAD is more prevalent and extensive in sub-Saharan African individuals. RECENT FINDINGS: A total of 38 studies reporting results from a median of 298 people living with HIV (PLWH) were included. The majority of studies (24) reported an association between HIV infection and PAD. Study design was heterogeneous. Traditional cardiovascular (tobacco smoking, diabetes mellitus, dyslipidaemia and hypertension) and HIV-associated (CD4 + T cell count, advanced HIV infection, viral load and antiretroviral therapy) risk factors were inconsistently reported. The most commonly reported risk factors were advanced age (odds ratio 1.09–4.66), HIV infection (odds ratio 1.22–4.92) and tobacco smoking (odds ratio range 1.08–5.96). Only 9 studies were conducted in sub-Saharan Africa. HIV infection is a risk factor for PAD although heterogeneous study design makes comparison of risk factors difficult. Further studies are required to understand the pathogenesis of PAD in PLWH, to identify biomarkers which may have diagnostic or prognostic significance in this group of patients.