SPECIAL SECTION: HIV/AIDS Kenneth H. Mayer, Section Editor Coronary Artery Disease and Human Immunode®ciency Virus Infection

Recent reports of myocardial infarctions in young persons infected with human immuno-de®ciency virus (HIV) who are receiving protease inhibitor therapy have raised concerns about premature coronary artery disease in this population. Endothelial dysfunction, hypercoagu-lability, hypertriglyceridemia, and abnormal coronary artery pathology were in fact associated with HIV infection prior to the availability of protease inhibitor therapy. Newly recognized risk factors, such as insulin resistance, hypercholesterolemia, and fat redistribution syndrome, may exacerbate underlying atherosclerotic risk for patients receiving protease inhibitors. Data on the incidence of myocardial infarction among these patients are largely limited to case reports but are of concern. Pending the availability of further data, it is prudent to monitor these patients for hyperlipidemia and consider interventions to modify cardiac risk factors. The heart is an organ frequently affected in patients with AIDS. Researchers have demonstrated cardiac involvement in as many as 45%±66 % of patients infected with HIV [1, 2]. Cardiac involvement generally occurs in the latter stages of the disease but can occur at any point. Although it can be clinicall