People living with HIV have a significantly higher prevalence of coronary plaque, even when their viral load is well-controlled with antiretroviral therapy, according to a substudy of the ongoing REPRIEVE trial published in JAMA Network Open.
The research, adapted from a National Institute of Allergy and Infectious Diseases email, found that approximately half of the participants with HIV had coronary plaque – cholesterol deposits that contribute to coronary artery disease. While most of the plaque was limited, concerning obstructions were identified in less than 3% of participants.
Investigators also observed a correlation between the presence of coronary plaque and elevated levels of markers indicating immune function and inflammation. This suggests that persistent immune activation, even with ART, may play a role in the development of cardiovascular disease in people with HIV.
Current Opinion in HIV and AIDS research published in 2022 indicates that HIV and the use of antiretroviral therapy are linked to an increased incidence of atherosclerotic cardiovascular disease (ASCVD). The study highlights that inflammation, measured by markers like IL-6 and C-reactive protein, predicts mortality in people with HIV.
A review published in February 2025 in MDPI notes the increasing attention to cardiovascular involvement in HIV patients, particularly as improved life expectancy extends the period during which these conditions can develop.
Research from 2017, as reported by The Cardiology Advisor, established a link between HIV/AIDS and cardiovascular disease, attributing the risk to both the virus itself and the effects of antiretroviral treatments.
The findings from the REPRIEVE trial substudy underscore the need for continued investigation into the immunological mechanisms driving chronic inflammation in people with HIV, including factors like clonal hematopoiesis and trained immunity, as well as the role of lipidomics.
The National Institute of Allergy and Infectious Diseases is continuing to fund research into these areas.
