[HIV infection : chronic disease with comorbidities]

While HIV therapy is highly efficient comorbidities come into the focus of HIV long-term treatment and prognosis. The pathogenesis of many comorbid diseases is determined not only by the biological effects of the HIV infection itself but also by lifestyle and long-term adverse reactions of antiviral treatment. The HIV specialist should nowadays be an all-round internist or needs a good infrastructure of cooperation. Cardiovascular risk factors in HIV infection include serum lipids, especially high LDL levels under antiviral treatment. They can be managed either by a switch of HIV therapy of by the addition of lipid-lowering agents. However, smoking habits and normalization of high blood pressure are also of importance. Further important comorbidities present in patients are viral hepatitis B or C, nephropathy (HIV or secondary) and changes of bone turnover resulting in lower bone mass and stability. Other aspects include vaccination status and prevention also for non-HIV associated carcinomas.