Etiology of HIV-related cardiomyopathy:

1. Myocardial infections with HIV
2. Opportunistic infections
3. Viral infections
4. Cardiotoxicity from drugs
   
5. Autoimmune response to viral infection
6. Nutritional deficiencies: selenium deficiency, alterations of vitamin B12, carnitine, growth hormone and thyroid hormone may cause left ventricular dysfunction
   

• Direct action of HIV on the myocardial tissue
• Proteolytic enzymes
• Cytokine mediators induced by HIV alone or with coinfections by other virus
  

Treatment

Therapy is similar to not HIV-associated cardiomyopathy and includes beta-blockers, aldosterone antagonists, diuretics, digoxine and ACE-Inhibitors. Opportunistic infections sould always be treated if associated.

Cardiac catheterization and endomyocardial biopsy should be performed if there is no response to medical therapy. In patients with risk factors for atheraosclerotic disease or clinical symptoms an angiography should be peformed.