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Published on: October 6, 2022
HIV and the body: a review of multidisciplinary management
J Rockstroh1, G Guaraldi, G Deray
1Department of Medicine, University of Bonn, Bonn, Germany.
Insights
Longer life for people with HIV means managing age-related diseases like cardiovascular disease and diabetes. Early detection and management of these comorbidities are crucial for HIV patients on antiretroviral therapy (ART).
Area of Science:
- Internal Medicine
- Infectious Diseases
- Geriatrics
Background:
- Effective antiretroviral therapy (ART) has increased life expectancy for individuals with human immunodeficiency virus (HIV).
- HIV-infected populations now face age-related diseases, often with higher prevalence and earlier onset compared to the general population.
- This is likely due to complex interactions between HIV, coinfections (Hepatitis B/C), and ART itself.
Purpose of the Study:
- To highlight the emerging challenge of age-related comorbidities in the aging HIV population.
- To emphasize the need for a new management approach for HIV physicians, including screening and monitoring.
- To provide practical guidance on managing common comorbidities in HIV-infected individuals.
Main Methods:
- Review of current literature on age-related diseases in HIV.
- Analysis of the impact of HIV infection, coinfections, and ART on comorbidity development.
- Discussion of clinical management strategies and educational initiatives.
Main Results:
- HIV-infected individuals experience higher rates and earlier onset of cardiovascular disease, dyslipidemia, glucose intolerance, and diabetes.
- A shift in HIV management is necessary, integrating comorbidity screening and monitoring.
- Physician education on diagnosing and treating these comorbidities is essential.
Conclusions:
- Increased lifespan in HIV necessitates proactive management of age-associated diseases.
- Integrated care models and continuous medical education are vital for addressing comorbidities in HIV patients.
- Early detection and management can improve long-term health outcomes for the aging HIV population.
Abstract:
The increase in the life expectancy achieved following the introduction of more effective antiretroviral therapy (ART) in recent years now means that the HIV-infected population are for the first time being exposed to the age-related diseases that affect the general population. Nevertheless, the prevalence of these diseases (which include cardiovascular disease, dyslipidaemia, glucose intolerance and diabetes) is higher, and their onset earlier in the HIV population, probably due to the complex interplay between HIV infection, coinfection with hepatitis B and C, and ART. As a result, HIV physicians are now required to adopt a new approach to the management of HIV, which involves screening and regular monitoring of all HIV-infected individuals for the presence of comorbidities and prompt referral to other clinical specialties when required. If this challenge to patient management is to be overcome, it is clear that educating physicians in the diagnosis and treatment of age-associated comorbidities is essential, either through ongoing programmes such as the HIV and the Body initiative, an overarching independent medical education programme established in 2007 and overseen by an independent Steering Committee, organized and funded by Gilead, and/or through internal training. To assist in this process, this article provides an overview of common comorbidities affecting HIV-infected persons and provides practical guidance on their management.
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