The changing face of HIV/AIDS in treated patients

Curr HIV Res. 2009 Jul;7(4):365-77. doi: 10.2174/157016209788680633.

Abstract

The spectrum of complications emerging in successfully treated HIV-infected patients has dramatically changed since the advent of HAART. Typical AIDS-defining illnesses have been substituted by new comorbid conditions that threaten even those patients who maintain virologic suppression. Proper management of cardiovascular risk, and early diagnosis of AIDS-related and, particularly, non-AIDS-related malignancies (including papilomavirus-related neoplasms) must be introduced into the routine of care. Hot areas of investigation include HIV-associated neurocognitive disorders, hepatitis B and C coinfection, non-alcoholic fatty liver disease, progressive multifocal leukoencephalopathy and tuberculosis. Bone and kidney long-term toxicities and lipoatrophy remain as issues of paramount importance. The identification and early treatment of immune reconstitution disease is also of major interest, specially in those patients starting their antiretroviral treatment with severe CD4 cell depletion. The present review focuses on these twelve areas of increasing interest for physicians currently facing successfully treated HIV+ patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • AIDS-Related Complex / epidemiology
  • AIDS-Related Complex / therapy
  • AIDS-Related Opportunistic Infections / epidemiology
  • AIDS-Related Opportunistic Infections / therapy
  • Acquired Immunodeficiency Syndrome / complications*
  • Acquired Immunodeficiency Syndrome / drug therapy*
  • Acquired Immunodeficiency Syndrome / epidemiology
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active / methods*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / therapy
  • HIV-Associated Lipodystrophy Syndrome / epidemiology
  • HIV-Associated Lipodystrophy Syndrome / therapy
  • Humans
  • Immune Reconstitution Inflammatory Syndrome / therapy
  • Lymphoma, AIDS-Related / epidemiology
  • Lymphoma, AIDS-Related / therapy
  • Neoplasms / epidemiology
  • Neoplasms / therapy

Substances

  • Anti-HIV Agents