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Cardiac disease in HIV infection

Symptomatic heart disease can affect up to 10% of HIV-positive patients and cause death in around 2%. Cardiovascular screening and risk factor management is recommended.
 In resource-poor countries where access to antiretroviral drugs is limited the typical manifestations are (1) HIV heart muscle disease—this occurs in the late stages of HIV infection, with dilated cardiomyopathy having a dismal prognosis, the median survival after diagnosis being about 100 days; standard therapy for heart failure should be considered; and (2) pericardial effusion—a common finding, but most are symptomless; significant effusions are often due to mycobacterial infection or malignant infiltration, particularly with non-Hodgkin’s lymphoma.