Heart Failure With Reduced Ejection Fraction in Human Immunodeficiency Virus Infection: The More Things Stay the Same

Heart failure is a recognized complication of human immunodeficiency virus (HIV) infection dating back to the first case report in 1986.¹ Over the subsequent years, the prevailing view of heart failure (HF) in HIV infection has evolved significantly. It is commonly suggested and at least 1 review has shown that in the era of antiretroviral therapy (ART), systolic dysfunction has become less common than diastolic dysfunction in people living with HIV (PLWH).² Heart failure with reduced ejection fraction (HFrEF) and HIV-associated cardiomyopathies are thought to be pertinent mostly to PLWH in the era before widespread access to ART or in developing countries.³ In this issue of JAMA Cardiology, robust data from a large epidemiological study provide key insights into the contemporary epidemiology of HF in PLWH.⁴