Title: The Changing Face of HIV/AIDS in Treated Patients
Volume: 7
Issue: 4
Author(s): Guillem Sirera, Bonaventura Clotet, Jose M. Miro, Antonella d'Arminio-Monforte, Pere Domingo, Maria J. Galindo, Josean Iribarren, Celia Miralles, Esteban Martinez, Josep M. Llibre, Sebastia Videla, Enrique Ortega, Jose Munoz, Juan A. Pineda, Eugenia Negredo, Cristina Tural and Vicenc Falco
Affiliation:
Keywords:
AIDS, papillomavirus, hepatitis, progressive multifocal leukoencephalopathy, neoplasia, immune reconstitution syndrome, AIDS dementia complex, cardiovascular disease
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.
