HIV, Cardiovascular Diseases, and Chronic Arsenic Exposure co-exist in a Positive Synergy

TL;DR

This paper reviews how chronic arsenic exposure may synergistically increase cardiovascular disease risks in HIV patients, highlighting environmental and biological interactions and recent modeling approaches.

Contribution

It provides a comprehensive overview of arsenic's impact on cardiovascular health in HIV patients, including new preliminary data and interdisciplinary modeling insights.

Findings

Arsenic exposure correlates with atherosclerosis and cardiovascular diseases.

HIV and ART contribute to cardiac and vascular pathology.

Environmental arsenic may facilitate HIV viral cycling and exacerbate CVD risk.

Abstract

Recent epidemiological evidences indicate that arsenic exposure increases risk of atherosclerosis, cardiovascular diseases and microangiopathies in addition to the serious global health concern related to its carcinogenic effects. In experiments on animals, acute and chronic exposure to arsenic directly correlates cardiac tachyarrhythmia, and atherogenesis in a concentration and duration dependent manner. Moreover, the other effects of long-term arsenic exposure include induction of non-insulin dependent diabetes by mechanisms yet to be understood. On the other hand, there are controversial issues, gaps in knowledge, and future research priorities of accelerated incidences of CVD and mortalities in patients with HIV who are under long-term anti-retroviral therapy (ART). Although, both HIV infection itself and various components of ART initiate significant pathological alterations in the myocardium and the vasculature, simultaneous environmental exposure to arsenic which is more convincingly being recognized as a facilitator of HIV viral cycling in the infected immune cells, may contribute an additional layer of adversity in these patients. In this mini-review which have been fortified with our own preliminary data, we will discuss some of the key current understating of chronic arsenic exposure, and its possible impact on the accelerated HIV/ART induced CVD. The review will conclude with notes on recent developments in mathematical modeling in this field that probabilistically forecast incidence prevalence as functions of aging and life style parameters, most of which vary with time themselves; this interdisciplinary approach provides a complementary kernel to conventional biology.