Cardiovascular Journal of Africa: Vol 26 No 2 (March/April 2015)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 2, March/April 2015 AFRICA 79
Key messages
• HIV infection is a multisystem disease with a diverse
clinical spectrum.
• HIV-associated vasculopathy is a unique entity confined
mainly to young individuals.
• The pathogenesis remains largely theoretical and entails
a complex interplay between inflammatory, opportunis-
tic infections and atherosclerotic components.
• The key histopathological findings include leucocy-
toclastic vasculitis of the vasa vasora, fragmentation
of the internal elastic lamina, variable intimo-medial
calcification, fibromuscular hyperplasia and transmural
inflammation.
• The availability of HAART has altered the natural histo-
ry of the disease profile, with atherosclerosis emerging as
a potentially ominous therapeutic challenge.
• Patients are managed along standard vascular surgical
guidelines as universal management guidelines have not
reached consensus to date.
• Long-term results of intervention are uncertain because
of suboptimal patient compliance.
• The exact indications for endovascular intervention
require further study.
We thank Mrs M Moodley for administrative support, Dr Y Sing for photo-
graphic assistance, the Bioethics Committee of the University of KwaZulu-
Natal for ethical approval (Protocol BF208/11) and the Medical Education
Partnership Initiative (MEPI) for partial study funding.
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