HIV Cardiomyopathy

Aka: HIV Cardiomyopathy

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II. Pathophysiology

  1. Dilated Cardiomyopathy (25% advanced HIV)
  2. Left Ventricular Dysfunction (21% advanced HIV)
  3. Myocardial fibrosis
    1. Present in up to 82% of HIV patients and often asymptomatic

III. Causes: HIV-Related Contributing Factors

  1. Older Antiretroviral therapy (AZT)
  2. Kaposi Sarcoma
  3. Opportunistic Infections (Cryptococcus, Toxoplasmosis)
  4. Malignant infiltration (e.g. Kaposi Sarcoma, Non-Hodgkin Lymphoma, Leiomyosarcoma)

IV. Causes: Infectious

  1. Mycobacterium
  2. Nocardia
  3. Cryptococcus neoformans
  4. Histoplasma capsulatum
  5. Aspergillus
  6. Cytomegalovirus (CMV)
  7. Epstein-Barr Virus (EBV)
  8. Toxoplasmosis

V. Findings

  1. Most are asymptomatic
  2. Usually clinically silent
  3. Pericardial Effusions (usually sterile) in 25%

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