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Cardiomyopathy, a disease of the heart muscle, is increasingly recognized as a significant complication for individuals living with human immunodeficiency virus (HIV), according to a comprehensive review published in Frontiers in Cardiovascular Medicine in September 2025. The review, authored by a multinational team of researchers, details the molecular mechanisms, clinical presentations, diagnostic approaches and treatment strategies related to HIV-associated cardiomyopathy.
Historically, as treatments for HIV have improved and life expectancy for those infected has increased, clinicians have observed a rise in non-infectious complications, including cardiovascular disease. Research published in 2009 in Clinical Cardiology noted that as more effective therapies extended the survival of HIV-infected patients, new late-stage complications, specifically HIV-related heart disease, began to emerge. The earlier focus on opportunistic infections often overshadowed the detection of cardiac issues.
The recent review highlights the complex interplay between HIV and the heart, moving beyond the understanding of direct viral infection of the myocardium. Researchers are now investigating the role of chronic inflammation, immune dysregulation, and the effects of antiretroviral therapies on cardiac function. The pathogenesis of HIV-associated cardiomyopathy remains a key area of study.
Advanced cardiac imaging techniques, as noted in a 2024 study published in the American Journal of Cardiology, are playing a crucial role in identifying cardiovascular pathology in people living with HIV. These techniques allow for earlier and more accurate diagnoses, even in the absence of overt symptoms. The study emphasized the increased incidence of cardiovascular pathology in this population.
While almost any agent causing disseminated infection in patients with Acquired Immunodeficiency Syndrome (AIDS) can potentially affect the heart, clinical evidence of cardiac disease is often subtle, particularly when compared to the more prominent manifestations in the brain and lungs. The review stresses the need for increased awareness among healthcare providers to ensure timely diagnosis and intervention.
The global health burden of HIV and its potential for long-term cardiovascular complications is substantial. The 2025 review underscores the importance of continued research to develop targeted therapies and improve the cardiovascular health of individuals living with HIV. Further investigation into the molecular mechanisms driving this association is ongoing at Northwestern University Feinberg School of Medicine, where several of the review authors are based.