{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:33:13Z","timestamp":1777710793165,"version":"3.51.4"},"reference-count":99,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>HIV-associated cardiomyopathy is a significant cause of morbidity and mortality among people living with HIV, contributing to heart failure, arrhythmia, and sudden cardiac death. Despite its clinical importance, its individual-patient clinical spectrum has not been systematically synthesized. We conducted a systematic review of published English-language case reports and small case series describing cardiomyopathy in HIV-infected individuals. Etiologies were classified using a framework distinguishing cardiomyopathy arising from uncontrolled HIV from that occurring despite virologic control. Stratified analyses examined temporal trends and geographic differences. We identified 99 patients (75 male, 20 female, 4 unspecified) from 27 countries (80% high-income). Median age was 35 years (IQR 28\u201345). Among 52 patients with CD4 data, median was 154 cells\/\u00b5L (IQR 84\u2013391); 52% had CD4 &lt; 200. Systolic dysfunction was present in 94% with echocardiographic data. Uncontrolled HIV phenotypes predominated (64%), but controlled phenotypes (21%)\u2014including drug-induced cardiomyopathy (n = 19, predominantly zidovudine-associated) and autoimmune or inflammatory mechanisms (n = 13)\u2014were substantial. Mortality declined across eras: 65% pre-ART, 32% early ART, 21% modern ART. Recovery occurred in 58%. HIV-associated cardiomyopathy is heterogeneous with improving outcomes across treatment eras. Systematic etiologic evaluation is warranted in all affected patients. The near absence of data from sub-Saharan Africa represents a critical gap.<\/jats:p>","DOI":"10.3390\/v18050510","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:46:11Z","timestamp":1777455971000},"page":"510","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Presentation, Etiology, and Outcomes of HIV-Associated Cardiomyopathy: A Systematic Review of Published Case Reports"],"prefix":"10.3390","volume":"18","author":[{"given":"Omar","family":"Hozayen","sequence":"first","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Hozayen","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2951-7244","authenticated-orcid":false,"given":"Benjamin J.","family":"Behers","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anas","family":"Abu Jad","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bashar","family":"Roumia","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8103-5574","authenticated-orcid":false,"given":"Matthew W.","family":"Miller","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph A.","family":"Stephenson-Moe","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Riveros","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Rosario","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen M.","family":"Hamad","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Sarasota Memorial Hospital, Florida State University, Sarasota, FL 34239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.amjcard.2015.10.030","article-title":"Patterns of cardiovascular mortality for HIV-infected adults in the United States: 1999 to 2013","volume":"117","author":"Feinstein","year":"2016","journal-title":"Am. 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