The changing face of HIV/AIDS in treated patients.
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.
Llibre
Josep M
JM
Lluita Contra la SIDA Foundation, University Hospital Germans Trias, Barcelona 08916, Spain. jmllibre@flsida.org
Falco
Vicenç
V
Tural
Cristina
C
Negredo
Eugenia
E
Pineda
Juan A
JA
Muñoz
Jose
J
Ortega
Enrique
E
Videla
Sebastia
S
Sirera
Guillem
G
Martinez
Esteban
E
Miralles
Celia
C
Iribarren
Josean
J
Galindo
Maria J
MJ
Domingo
Pere
P
d'Arminio-Monforte
Antonella
A
Miro
Jose M
JM
Clotet
Bonaventura
B
D000386:AIDS-Related Complex / Q000453:epidemiology / Q000628:therapy; D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000628:therapy; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000628:therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000628:therapy; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology / Q000628:therapy; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy
D019380:Anti-HIV Agents