Thrombotic and cardiovascular events in HIV infection (Review).

Human Immunodeficiency Virus (HIV) infection has nowadays become a chronic disease, due to the introduction of antiretroviral therapy (ART), which has improved both life expectancy and quality of life of patients with HIV but has also led to the emergence of previously unrecognized complications. Thromboembolic events constitute a serious and frequent comorbidity in patients with HIV. The thrombogenic potential of HIV infection is multifactorial and is attributed to persistent chronic inflammation, endothelial dysfunction and ART itself, mainly through the resulting metabolic alterations. Co-infections and gut microbe translocation observed in patients with HIV, also maintain the inflammatory prothrombotic microenvironment. Individuals with HIV are at higher risk for venous thromboembolism and cardiovascular disease, compared with general population. Among patients with HIV, those receiving specific ART regimens have a significant higher risk for myocardial infraction. HIV infection is also involved in other coagulation disorders, such as heparin-induced thrombocytopenia and thrombotic thrombocytopenic purpura. Therapeutic choices do not differ from individuals without HIV but should be cautiously administered due to drug interactions. Further studies are required in order to fully understand the pathophysiological mechanisms involved and develop new treatment options for patients with HIV.