Pathogenesis of HIV-associated vasculopathy

The vascular endothelium serves numerous diverse functions vital to the proper homeostasis of all organs. Beyond providing a conduit for oxygen delivery, the endothelium directs inflammatory cell traffic, controls thrombosis and macromolecular transport, presents a source of and target for cytokines and growth factors, and coordinates angiogenic activity. Accordingly, acute and chronic illnesses that derange endothelial function-such as diabetes mellitus, sepsis, and atherosclerosis-cause widespread, protean, and often severe manifestations of disease. To this list of systemic vascular diseases we add AIDS. The vascular endothelium is a silent target of human immunodeficiency virus-1 (HIV-1), and infection of individuals with HIV-1 results in a series of diffuse vascular processes that frequently progress unrecognized.