Thomas McNeil1, Emily Rowe1. 1. Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Abstract
BACKGROUND: Patients with human immunodeficiency virus (HIV) infection have higher rates of cardiovascular disease, metabolic disorders and malignancy than their uninfected peers. AIM: To survey the health of a South Australian cohort of long-term HIV patients, who had been diagnosed with HIV prior to the availability of combination antiretroviral therapy. METHODS: Data from 88 patients were collected retrospectively across four domains: demographics, HIV history, antiretroviral medication and medical comorbidity. RESULTS: There were high rates of cardiovascular risk factors, in particular active smoking, dyslipidaemia and diabetes mellitus, which translated into a high rate of ischaemic heart disease and cerebrovascular accidents. A large proportion of the patients suffered depression and cognitive impairment. Approximately one-fifth of the cohort had been diagnosed with a malignancy, with anal cancer being the most prevalent. Many patients had experienced permanent toxicity from antiretroviral therapy. CONCLUSION: The present study showed high rates of 'non-HIV morbidity' in a group of long-term HIV patients in South Australia. Clinicians should aggressively modify cardiovascular risk factors, ensure appropriate immunisations, monitor mental health and consider targeted malignancy screening in these patients. A robust clinical infrastructure and multidisciplinary team is required to facilitate the complex care needs of long-term HIV patients.
BACKGROUND:Patients with human immunodeficiency virus (HIV) infection have higher rates of cardiovascular disease, metabolic disorders and malignancy than their uninfected peers. AIM: To survey the health of a South Australian cohort of long-term HIVpatients, who had been diagnosed with HIV prior to the availability of combination antiretroviral therapy. METHODS: Data from 88 patients were collected retrospectively across four domains: demographics, HIV history, antiretroviral medication and medical comorbidity. RESULTS: There were high rates of cardiovascular risk factors, in particular active smoking, dyslipidaemia and diabetes mellitus, which translated into a high rate of ischaemic heart disease and cerebrovascular accidents. A large proportion of the patients suffered depression and cognitive impairment. Approximately one-fifth of the cohort had been diagnosed with a malignancy, with anal cancer being the most prevalent. Many patients had experienced permanent toxicity from antiretroviral therapy. CONCLUSION: The present study showed high rates of 'non-HIV morbidity' in a group of long-term HIVpatients in South Australia. Clinicians should aggressively modify cardiovascular risk factors, ensure appropriate immunisations, monitor mental health and consider targeted malignancy screening in these patients. A robust clinical infrastructure and multidisciplinary team is required to facilitate the complex care needs of long-term HIVpatients.
Authors: Fátima Brañas; Mª José Galindo; Miguel Torralba; Antonio Antela; Jorge Vergas; Margarita Ramírez; Pablo Ryan; Fernando Dronda; Carmen Busca; Isabel Machuca; Mª Jesús Bustinduy; Alfonso Cabello; Matilde Sánchez-Conde Journal: PLoS One Date: 2022-03-30 Impact factor: 3.240