Malignancies

Kaposi's Sarcoma

When Kaposi’s sarcoma involves the heart, the epicardial surface is a common site of involvement. At autopsy, the pericardium and the epicardial fat show the typical nodular coalescent dark-red lesions or viola­ceous plaques [2, 3].

Fig. 7 Fibrinous pericarditis by Mycobacteri­um avium intracellulare in an HIV-infected subject who died of congestive heart fail­ure. (Courtesy of Prof. D. Scevola, Depart­ment of Infectious and Parasitic Disease, University of Pavia, Italy)

Lymphomas

In contrast to non-Hodgkin’s lymphomas in seronegative patients, which are epicardial or pericardial in location, in AIDS patients, the tumor is most often located within the myocardium or in the subendocardial layer [2]. There may be pericardial effusion, with a mass lesion of the heart sometimes prolaps­ing across the tricuspid valve or involving the inferior portions of both ventricles.

References

1. Barbaro G, Di Lorenzo G, Grisorio B, Barbarini G and the Gruppo Italiano per lo Studio Cardio- logico dei pazienti affetti da AIDS Investigators (1998) Cardiac involvement in the acquired immunodeficiency syndrome: a multicenter clinical-pathological study. AIDS Res Hum Retroviruses 14:1071-7107

2. D’Amati G, Di Gioia CRT, Gallo P (2001) Patho­logical findings of HIV-associated cardiovascu­lar disease. Ann NY Acad Sci 946:23-45

3. Klatt EC (2003) Cardiovascular pathology in AIDS. Adv Cardiol 40:23-48

4. Aretz HT (1987) Myocarditis: the Dallas criteria. Hum Pathol 18:619-624

5. Barbaro G, Di Lorenzo G, Soldini M et al (1999) Intensity of myocardial expression of inducible nitric oxide synthase influences the clinical course of human immunodeficiency virus-asso­ciated cardiomyopathy.

6. Herskowitz A, Tzyy-Choou W, Willoughby SB et al (1994) Myocarditis and cardiotropic viral infection associated with severe left ventricular dysfunction in late-stage infection with human immunodeficiency virus. J Am Coll Cardiol 24:1025-1032

7. Barbaro G, Barbarini G, Pellicelli AM (2001) HIV-associated coronary arteritis in a patient with fatal myocardial infarction. N Engl J Med 344:1799-1800

8. Twu C, Liu QN, Popik W et al (2002) Cardiomy­ocytes undergo apoptosis in human immunode­ficiency virus cardiomyopathy through mito­chondrion and death receptor-controlled path­ways. Proc Natl Acad Sci USA 99:14386-14391

9. Barbaro G, Klatt EC (2003) Highly active anti­retroviral therapy and cardiovascular complica­tions in HIV-infected patients. Curr Pharm Des 9:1475-1481

10. Holmberg SD, Moorman AC, Williamson JM et al (2002) Protease inhibitors and cardiovascular outcomes in patients with HIV-1. Lancet 360:1747-1748

11. Barbaro G, Di Lorenzo G, Cirelli A et al (2003) An open-label, prospective, observational study of the incidence of coronary artery disease in patients with HIV receiving highly active anti­retroviral therapy. Clin Ther 25:2405-2418

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13. Bozzette SA, Ake CF, Tam HK et al (2003) Car­diovascular and cerebrovascular events in patients treated for human immunodeficiency virus infection. N Engl J Med 348:702-710

14. The Data Collection on Adverse Events of Anti­HIV Drugs (DAD) Study Group (2003). Combina­tion antiretroviral therapy and the risk of my­ocardial infarction. N Engl J Med 349: 1993-2003

15. Barbaro G, Di Lorenzo G, Grisorio B, Barbarini G and the Gruppo Italiano per lo Studio Cardio- logico dei pazienti affetti da AIDS investigators (1998) Cardiac involvement in the acquired immunodeficiency syndrome: a multicenter clinical-pathological study. AIDS Res Hum Retroviruses 14:1071-1077

16. Duong M, Dubois C, Buisson M et al (1997) Non­Hodgkin’s lymphoma of the heart in patients infected with human immunodeficiency virus. Clin Cardiol 20:497-502

17. Sanna P, Bertoni F, Zucca E et al (1998) Cardiac involvement in HIV-related non-Hodgkin’s lym­phoma: a case report and short review of the lit­erature. Ann Hematol 77:75-78

18. Dal Maso L, Serraino D, Franceschi S (2001) Epi­demiology of HIV-associated malignancies. Can­cer Treat Res 104:1-18

19. Heidenreich PA, Eisenberg MJ, Kee LL et al (1995) Pericardial effusion in AIDS: incidence and survival. Circulation 92:3229-3234

20. Pugliese A, Isnardi D, Saini A et al (2000) Impact of highly active antiretroviral therapy in HIV-positive patients with cardiac involvement. J Infect 40:282-284