Cardiovascular disease (CVD), a commonly used term for diseases of the heart and blood vessels, is the number one cause of death world-wide [1]. It is projected that annual global cardiovascular deaths will increase

from 16.7 million in 2002 to 23.9 million by 2030 [1]. The selleck chemical HIV pandemic has contributed significantly to mortality rates in many countries over the past three decades. However, the introduction of effective antiretroviral therapy (ART) has substantially reduced AIDS-related mortality [2, 3] and thus non-HIV-related mortality, such as that attributable to CVD, has become increasingly important for the estimated 33.3 million people living with HIV (PLHIV) [4, 5]. There is no consensus on the risk of CVD associated with HIV infection and the use of ART [6, 7]. Therefore, in this study we conducted a systematic review and meta-analysis of the published literature to assess the relative risk (RR) of CVD among PLHIV compared with the HIV-uninfected population. We also investigated the RR of CVD associated with the use and duration of ART, including different classes of ART drugs administered.

We conducted a comprehensive literature search of the peer-reviewed mTOR inhibitor publications through Medline, during July–November 2010, and conference proceedings of the Conference on Retroviruses and Opportunistic Infections (CROI) and International AIDS Society with the following search keywords: ‘HIV or human immunodeficiency Phosphatidylinositol diacylglycerol-lyase virus or AIDS or acquired immunodeficiency syndrome’ AND ‘cardiovascular or CVD or myocardial infarction or heart disease or vascular disease or coronary artery disease or coronary heart disease or myocarditis or cardiomyopathy or cardiac disease or cardiac arrhythmias’ AND ‘relative risk or risk ratio or RR or odds ratio or OR or hazard ratio or HR or incidence’. We included

cohort studies and randomized controlled trials that reported HIV-infected adults in at least one study arm. We categorized studies that reported on ART according to the three major drug classes [protease inhibitor (PI), nonnucleoside reverse transcriptase inhibitor (NNRTI) and nucleoside reverse transcriptase inhibitor (NRTI)] compared with the outcome among PLHIV not on ART. The primary outcome for our analysis was the incidence of CVD. For the purpose of this review, CVD includes myocardial infarction (MI), ischaemic heart disease (IHD), cardiovascular and cerebrovascular disease (CVD) and coronary heart disease (CHD). Studies that estimated the risks using incidence rate ratio (IRR), relative risk (RR), odds ratio (OR) or hazard ratios (HR) were included. We screened the titles of all articles for appropriateness, followed by the abstract, before retrieval of the full text. Studies that reported HIV and/or AIDS and CVD, and provided estimates of risk factors or estimates of RR, were included in the analysis.