**7. Infective endocarditis in HIV**

The epidemiology and clinical profile of infective endocarditis in HIV infection are the same as in uninfected individuals [73]. The one setting where HIV is associated with increased risk of infective endocarditis is intravenous drug abuse. *Staphylococcus aureus, Streptococcus viridans* and Salmonella species are the most common organisms and the tricuspid valve is most involved in intravenous drug users developing infective endocarditis [74, 75]. Nonbacterial (marantic) endocarditis has been described in HIV, usually clinically silent and manifests with large, friable, sterile vegetations on the cardiac valves, which can lead to pulmonary embolization [75]. Patients with low CD4 counts have a poorer prognosis when they develop infective endocarditis [76]. Rates of infective endocarditis have decreased with the advent of ARV therapy [76]. When intravenous drug use is excluded, HIV infection has not been shown to be a risk factor for infective endocarditis [77].
