**9. Cardiovascular malignancy in HIV**

Cardiac malignancy usually manifests late in HIV disease. Kaposi's sarcoma and cardiac lymphoma are the main malignancies associated with HIV [89]. Non-Hodgkin lymphoma occurs 25–60 times more in HIV infected patients [90]. Cardiac lymphoma can infiltrate the myocardium, the subendocardial layer or be located within pericardial effusion [90]. Clinical features include dyspnoea, right-sided heart failure, heart failure, chest pain and arrhythmia. Presentations range from asymptomatic to cardiac tamponade, myocardial infarction, heart failure or conduction abnormalities [91].

In the pre-ART era, the prevalence of Kaposi's sarcoma from autopsy studies ranged from 12 to 28%, however, cardiac sarcomas were rare [6, 62]. In Kaposi's sarcoma, the coronary arteries are not affected. The incidence of non-Hodgkin lymphoma is not related to the level of immunosuppression and has not changed with ART use [92].
