Relationship Between HIV-Associat­ed Cardiomyopathy and Encepha­lopathy

HIV-infected patients with encephalopathy are more likely to die of congestive heart failure than are those without encephalopa­thy (hazard ratio: 3/4) [32, 33]. Cardiomy­opathy and encephalopathy may both be traceable to the effects of HIV reservoir cells in the myocardium and the cerebral cortex. These cells may hold HIV-1 on their surfaces for extended time periods even after antiretroviral treatment, and they may chronically release cytotoxic cytokines (TNF-α, IL-6, and endothelin-1), which con­tribute to progressive and late tissue dam­age in both systems (Fig. 6). Because the reservoir cells are not affected by treat­ment, the effect is independent of whether the patient receives HAART.