Complications of HIV: lipodystrophy, anemia, renal, cardiovascular, and bone diseases

Diagnosis of a human immunodeficiency virus (HIV) infection has long been associated with a short life expectancy, with care centered on the treatment and prevention of opportunistic infections and symptom management. As progress has been made through better understanding of the virus, and improved medications and treatments, persons with HIV are living longer, more productive lives. In addition to the scientific breakthroughs in treating the HIV-infected patient, more is also being learned about the long-term effects of the treatments and the virus, such as lipodystrophy syndrome. Comorbid diseases are also becoming more common in patients with HIV, such as anemia, bone disease, renal disease, and cardiac disease, which may be the result of metabolic complications or HIV itself. There is a vast array of comorbid diseases and adverse effects of medications in persons with HIV disease; and information regarding these issues is constantly changing as research continues to show more about their pathophysiology and treatment options. The most common comorbid disorders will be explored. A detailed explanation of the lipodystrophy syndrome and its common metabolic manifestations will be presented, including current research. In addition, the etiology, clinical findings, diagnosis, and treatment of the most common comorbid diseases associated with anemia and the bone, renal, and cardiovascular systems will be presented as they relate to the HIV-infected patient. All of the descriptions are designed for the primary care provider, who may be in contact with an HIV-infected patient whose differential diagnoses consist of one or more of these disorders.