Guidelines for the prevention of cardiovascular risk in HIV-infected patients treated with antiretroviral drugs

The objective proposed by various health authorities for the year 2010 is to reduce CHD deaths to no more than 51 in 100.000, "enhancing the cardiovasclular health and quality of life of all Americans through imprevement of medical management, prevention and control of risk factors, and promotion of ehalthy lifestyle behaviors". In light of this policy also adopted by the European Union, particolar attention must be devoted to HIV-infected individuals who, in the near future, could represent an emerging population at a more elevated risk of CHD due to the prolonged life expectancy and/or metabolic disturbances induced by therapy. Elevated triglycerides (TG), low-density lipoprotein (LDL), cholesterol, very low-density lipoprotein (VLDL) cholesterol, and reduced livels of high-density lipoprotein (HDL) cholesterol are associated with body-fat redistribution characterized by visceral fat accumulation, peripheral lipodystrophy/lipoatrophy, and CHD. It has been reported that 5-75% of HIV patients receiving HAART experience a worse lipid metabolism and body-fat distribution after 10-12 months of therapy. Our guidelines, based on our own adn the experience of other, meet the intervention criteria defined by the American National Cholesterol Education Program (NCEP), including evaluation criteria, diet prescription, drug and exercise treatment - preliminary discussion included in The Pavia COnsensus Statement, October 2001, the recommendations of the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group (AACTG), and the 2007 updated scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity and Metabolism. Our study is also based on algorithms and approaches developed in classic phusiology and sports Medicine for healthy people, the elderly, diseases such as diabetes and CVD.