Table:

Manuscript overview by section with key points

Part I: Cardiovascular Complications of HIV/AIDS
Epidemiology
	HIV has transitioned from a generally fatal disease to a chronic and manageable disease because of increased access to antiretroviral therapy (ART) Compared to uninfected people, people living with HIV (PLWH) have an elevated risk of myocardial infarction (MI), heart failure (HF), pulmonary hypertension, stroke, and arrhythmias.
Pathophysiology
Atherosclerotic CVD (ASCVD): Traditional Risk Factors	Smoking and dyslipidemia are important traditional risk factors in the HIV+ population Protease inhibitors may cause dyslipidemia and metabolic syndrome, but newer classes of ART such as integrase inhibitors are less metabolically toxic
ASCVD: HIV-Related Factors	HIV-specific factors such as low CD4+ T-cell count and elevated viral load are associated with higher risk of ASCVD events Chronic inflammation and immune activation are important non-traditional drivers of ASCVD risk in treated HIV infection
Non-Atherosclerotic CVD	Myocardial inflammation, co-infection, environmental factors (alcohol and drugs) and viral replication may be implicated to varying degrees in the development of HIV-associated HF, pulmonary hypertension, and arrhythmias
Part II: HIV-Associated CVD in HIV Endemic Countries (HIV-ECs)
Patterns of Cardiovascular Morbidity and Mortality in HIV-ECs	In HIV-ECs, there is a double burden of endemic (dilated cardiomyopathy, rheumatic heart disease, and others) and emerging (hypertensive and ischemic) causes of CVD.
Traditional CVD Risk Factors in HIV-ECs	With the adoption of “Western lifestyles” in HIV-ECs—tobacco and alcohol use, sedentary lifestyles, and atherogenic fast food consumption increasingly contribute to the burden of CVD Hypertension is common in HIV-ECs, with poor awareness and low rates of treatment.
Unique CVD Risk Considerations among PLWH in HIV-ECs	Substantial numbers of HIV+ persons in HIV-ECs still lack access to ART and are thus at risk for CVD complications of uncontrolled infection and AIDS Although untreated HIV infection is associated with lower blood pressure, hypertension commonly results after ART initiation and is an important driver of CVD risk among PLWH in HIV-ECs.
Preparing for an Increased Burden of Cardiovascular Risk in HIV-Endemic Countries in the Modern ART Era
CVD Risk Stratification Tools	Laboratory-based risk stratification tools may not be feasible to apply in resource-limited settings in HIV-ECs. Further research is needed to evaluate optimal risk estimation tools among PLWH in HIV-ECs
Health Systems Strengthening	Interventions at the individual and community level to treat and prevent HIV-associated CVD complications in HIV-ECs are being implemented, with promising early results. Ideally, health systems interventions would integrate screening for CVD and its risk factors into chronic HIV care