The widespread availability of potent combination anti-HIV therapy (commonly called ART or HAART) in Canada, Australia, the U.S. and Western Europe has greatly improved the health of HIV-positive people. Deaths from AIDS-related infections are now much less common, at least among HIV-positive people who get tested, make regular clinic visits and take ART every day exactly as directed.
Inflammation
HIV infection activates the immune system, causing it to release chemical signals that incite inflammation throughout the body. This is a normal response to an infection, as the body mobilizes to contain an invading germ. However, in many cases, the immune system is not able to squelch HIV. Treatment for HIV significantly reduces levels of HIV-related inflammation, but ART does not eliminate the inflammation associated with HIV infection, perhaps because the virus continues to persist, albeit at relatively low levels. As a result, inflammation persists and this carries the potential to gradually degrade many organ systems.
Gender
Several studies have found a link between an increased risk for serious cardiovascular disease (heart attack, stroke) and HIV infection, particularly among men. However, comparatively less is known about the impact of prolonged HIV infection on the cardiovascular health of women.
Observational studies in France and North America suggest that HIV-positive women have an increased risk for heart attack, in some cases as high as three-fold greater than among HIV-negative women. Precisely why this increased risk occurs has not been clear, until very recently.
