CVD Risk in HIV — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

EasyHIV MedicineCVD Risk in HIVSCE Infectious Diseases

A 35-year-old woman with HIV (CD4 600, VL <50 on ART for 8 years) asks whether she is at increased cardiovascular risk compared to the general population despite well-controlled HIV. What is the current evidence?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Yes — PLWH have approximately 1.5–2× excess CVD risk even with viral suppression, driven by chronic immune activation and inflammation; standard CVD risk management (QRISK3, statins, BP control) is essential

People with well-controlled HIV have a persistent ~1.5–2 fold increased cardiovascular risk compared to the general population. This excess risk is driven by: chronic HIV-associated inflammation (elevated IL-6, D-dimer, CRP), immune activation (even with suppressed VL), endothelial dysfunction, and traditional risk factors (higher smoking rates in PLWH). QRISK3 should be used for risk assessment (it includes HIV as a variable). Statins, BP control, and smoking cessation are the cornerstones of management. Abacavir (previously associated with CVD) has been removed from BHIVA first-line.

Reference: BHIVA 2025 – CVD in HIV; EACS 2025 – Metabolic complications; D:A:D Study