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J Leukoc Biol. 2010 Apr;87(4):589-98. doi: 10.1189/jlb.0809580. Epub 2009 Dec 1.

The macrophage: the intersection between HIV infection and atherosclerosis.

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  • 1Centre for Virology, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne 3004, Australia.


HIV-infected individuals are at increased risk of coronary artery disease (CAD) with underlying mechanisms including chronic immune activation and inflammation secondary to HIV-induced microbial translocation and low-grade endotoxemia; direct effects of HIV and viral proteins on macrophage cholesterol metabolism; and dyslipidemia related to HIV infection and specific antiretroviral therapies. Monocytes are the precursors of the lipid-laden foam cells within the atherosclerotic plaque and produce high levels of proinflammatory cytokines such as IL-6. The minor CD14+/CD16+ "proinflammatory" monocyte subpopulation is preferentially susceptible to HIV infection and may play a critical role in the pathogenesis of HIV-related CAD. In this review, the central role of monocytes/macrophages in HIV-related CAD and the importance of inflammation and cholesterol metabolism are discussed.

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