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HIV-1 Spectrum Disease, Psychological Distress, and Cardiometabolic Risk

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Handbook of Cardiovascular Behavioral Medicine

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Abstract

A little more than a decade after the advent of highly active antiretroviral therapy (HAART), it is clear that the survival of HIV-infected individuals has substantially improved. However, with extended life span, there is increasing prevalence of chronic diseases, including obesity, type 2 diabetes mellitus, and atherosclerotic and arteriosclerotic diseases. In conjunction with the threat of mortality, HIV spectrum disease is associated with significant social stigma and numerous chronic stressors that are often unpredictable and uncontrollable, resulting in sustained elevations of negative affect and psychological distress. The psychoneuroimmunological literature indicates that psychological factors may deleteriously influence key aspects of immunological regulation, which could not only facilitate HIV disease severity but also exacerbate subclinical cardiometabolic pathophysiology. Indeed, the literature has noted an increased myocardial infarction risk in HIV/AIDS patients, especially since the introduction of HAART medications. Comorbid subclinical cardiometabolic conditions reminiscent of metabolic syndrome, as well as elevated blood pressure and vascular endothelial dysfunction, have been reported with increased prevalence in HIV-infected persons with HAART exposure. In addition to the depletion of CD4+ T-helper cells and a progressive decline in immune function, study findings indicate that the HIV infection promotes immune activation and heightened proinflammatory status.

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Acknowledgments

Research findings from this laboratory reported in this chapter were derived from research grants (DA13128, HL72712, and HL36588) from the National Institute on Drug Abuse and the National Heart, Lung, and Blood Institute of the National Institutes of Health and a career development award (AT004945) from the National Center for Complementary and Alternative Medicine.

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Authors and Affiliations

  1. Departments of Psychology and Biomedical Engineering, University of Miami, Coral Gables, FL, USA

    Barry E. Hurwitz

  2. Behavioral Medicine Research Center and Division of Endocrinology and Metabolism, School of Medicine, University of Miami, Miami, FL, USA

    Barry E. Hurwitz

  3. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Roger C. McIntosh

  4. Department of Psychology, Rowan University, Glassboro, NJ, USA

    Jeffrey M. Greeson

  5. Behavioral Medicine Research Center, University of Miami, Miami, FL, USA

    Roger C. McIntosh

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  1. Barry E. Hurwitz
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  2. Roger C. McIntosh
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  3. Jeffrey M. Greeson
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Correspondence to Barry E. Hurwitz .

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Editors and Affiliations

  1. Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, USA

    Shari R. Waldstein

  2. Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands

    Willem J. Kop

  3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    Edward C. Suarez

  4. Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    William R. Lovallo

  5. Division of Gerontology Geriatrics and Palliative Medicine Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Leslie I. Katzel

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Hurwitz, B.E., McIntosh, R.C., Greeson, J.M. (2022). HIV-1 Spectrum Disease, Psychological Distress, and Cardiometabolic Risk. In: Waldstein, S.R., Kop, W.J., Suarez, E.C., Lovallo, W.R., Katzel, L.I. (eds) Handbook of Cardiovascular Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-85960-6_59

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