scholarly journals Insulin Resistance and Glucose Dysregulation in Hiv Treated Patients

2018 ◽  
Vol 6 (03) ◽  
Author(s):  
Prof. Xu Yancheng ◽  
Salama A. ALI ◽  
Ass. Prof Chen Xiaoqi
Keyword(s):  
Insulin Resistance ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Current Knowledge ◽  
Antiretroviral Drugs ◽  
Fat Accumulation ◽  
Highly Active ◽  
Age Related ◽  
Glucose Dysregulation

The emergence of a new HIV infected elderly population as a result of chronic use of highly active antiretroviral therapy (HAART) has attributed to the increase of metabolic disorders particularly insulin resistance(IR) and diabetes, dyslipidemia and lipodystrophy.The pathogenesis of these metabolic derangements is complex and multifactorial and could be a consequence of an interplay between traditional age-related risk factors, HIV infection, antiretroviral therapy effects, the inflammatory effect and immune activation in this population. IR in HIV infection has numerous causes which include not only the direct effects of antiretroviral drugs but also factors such as aging and restoration to health accompanied by fat accumulation. Studies have shown that insulin levels increase over time with antiretroviral therapy, likely the result of improved health, fat accumulation, and aging, and that increases in visceral fat and upper trunk fat are associated with a higher risk of IR in HIV infected and uninfected individuals. Since metabolic and cardiovascular disease (CVD) increase with aging, knowledge of the optimal management of these conditions is essential for practitioners caring for HIV infected patients including endocrine subspecialists. This review aims to synthesize the current knowledge on insulin resistance and dysregulation of glucose on treated HIV population

scholarly journals HIV and Aging – Perhaps Not as Dramatic as We Feared?

Gerontology ◽  
2018 ◽  
Vol 64 (5) ◽  
pp. 446-456 ◽  
Author(s):  
Tanja Engel ◽  
Marieke Raffenberg ◽  
Catia Marzolini ◽  
Matthias Cavassini ◽  
Helen Kovari ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Insulin Resistance ◽  
Antiretroviral Therapy ◽  
Renal Insufficiency ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Metabolic Complications ◽  
Neurocognitive Dysfunction ◽  
Highly Active

Ever since the introduction of highly active antiretroviral therapy (ART) in 1995, HIV infection has been linked to “metabolic” complications (insulin resistance, dyslipidemia, osteoporosis, and others). Studies suggested increased rates of myocardial infarction, renal insufficiency, neurocognitive dysfunction, and fractures in HIV-postitive patients. Even long-term suppression of HIV seemed to be accompanied by an excess of deleterious inflammation that could promote these complications. The aims of this viewpoint paper are to summarize recent data and to examine the possibility that the problem of aging-related morbidity in HIV might not be as dramatic as previously believed.

Beneficial and Detrimental Effects of Antiretroviral Therapy on HIV-Associated Immunosenescence

Chemotherapy ◽  
2018 ◽  
Vol 63 (2) ◽  
pp. 64-75 ◽  
Author(s):  
Ornella Franzese ◽  
Maria Luisa Barbaccia ◽  
Enzo Bonmassar ◽  
Grazia Graziani
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Immunological Response ◽  
Antiretroviral Drugs ◽  
Hiv Patients ◽  
Progressive Decline ◽  
Highly Active ◽  
Anti Hiv Agents

Since the introduction of highly active antiretroviral therapy more than 2 decades ago, HIV-related deaths have dramatically decreased and HIV infection has become a chronic disease. Due to the inability of antiretroviral drugs to eradicate the virus, treatment of HIV infection requires a systemic lifelong therapy. However, even when successfully treated, HIV patients still show increased incidence of age-associated co-morbidities compared with uninfected individuals. Virus- induced immunosenescence, a process characterized by a progressive decline of immune system function, contributes to the premature ageing observed in HIV patients. Although antiretroviral therapy has significantly improved both the quality and length of patient lives, the life expectancy of treated patients is still shorter compared with that of uninfected individuals. In particular, while antiretroviral therapy can contrast some features of HIV-associated immunosenescence, several anti-HIV agents may themselves contribute to other aspects of immune ageing. Moreover, older HIV patients tend to have a worse immunological response to the antiviral therapy. In this review we will examine the available evidence on the role of antiretroviral therapy in the control of the main features regulating immunosenescence.

scholarly journals Hematological Profile of HIV-Infected Patients on First-Line Highly Active Antiretroviral Therapy and Its Correlation With CD4 Count

2021 ◽  
Author(s):  
John Jospeh Diamond Princy ◽  
Kshetrimayum Birendra Singh ◽  
Ningthoujam Biplab ◽  
Ningthoukhongjam Reema ◽  
Rajesh Boini ◽  
...  
Keyword(s):  
Platelet Count ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Total Leukocyte Count ◽  
Hiv Patients ◽  
Positive Correlation ◽  
Highly Active ◽  
The Mean

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.

scholarly journals Meta-analysis of adherence to highly active antiretroviral therapy in patients with HIV infection in China

AIDS Care ◽  
2018 ◽  
Vol 31 (8) ◽  
pp. 913-922 ◽  
Author(s):  
Yuan-Yuan Wang ◽  
Yu Jin ◽  
Chang Chen ◽  
Wei Zheng ◽  
Shi-Bin Wang ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Meta Analysis ◽  
Highly Active

scholarly journals Persistence of Genital Tract T Cell Responses in HIV-Infected Women on Highly Active Antiretroviral Therapy

2010 ◽  
Vol 84 (20) ◽  
pp. 10765-10772 ◽  
Author(s):  
Nonhlanhla N. Mkhize ◽  
Pamela P. Gumbi ◽  
Lenine J. Liebenberg ◽  
Yuan Ren ◽  
Peter Smith ◽  
...  
Keyword(s):  
T Cell ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Genital Tract ◽  
T Cell Responses ◽  
Antiretroviral Drugs ◽  
Cd4 T Cell ◽  
Cell Responses ◽  
Highly Active ◽  
Cell Counts

ABSTRACT Initiation of highly active antiretroviral therapy (HAART) for HIV-infected individuals is associated with control of viremia, improved CD4 counts, and declining systemic HIV-specific immune responses. While HAART effectively reduces plasma viremia, it remains unclear how effectively antiretroviral drugs reach mucosal surfaces, such as those of the genital tract. The aim of this study was to determine the effect of HAART on genital tract CD4 T cell reconstitution, HIV shedding, and HIV-specific T cell responses. Cervical cytobrush and blood specimens were obtained from 35 HIV-infected, HAART-naïve women and 27 women on HAART in order to investigate HIV Gag-specific T cell responses by intracellular gamma interferon (IFN-γ) staining. Interleukin 1β (IL-1β), IL-6, and IL-8 concentrations were measured by enzyme-linked immunosorbent assays (ELISA). We show that for HIV-infected women, HAART is associated with significantly improved CD4 T cell counts both in blood and at the cervix. While HAART effectively suppressed both blood and cervical viremia, HIV-specific CD8 T cell responses in blood were lost, while those at the cervix were preserved.

Osteonecrosis of the knee in a patient receiving antiretroviral therapy

2002 ◽  
Vol 13 (11) ◽  
pp. 792-794 ◽  
Author(s):  
S H Allen ◽  
A L Moore ◽  
M J Tyrer ◽  
B J Holloway ◽  
M A Johnson
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Avascular Osteonecrosis ◽  
Antiretroviral Agents ◽  
Highly Active ◽  
The Right

A case of avascular osteonecrosis of the right knee is described in a patient with HIV infection. The patient had been receiving highly active antiretroviral therapy for two years prior to presentation. Osteonecrosis is an uncommon albeit serious complication of HIV infection and is associated with use of antiretroviral agents.

Response to Highly Active Antiretroviral Therapy According to Duration of HIV Infection

2001 ◽  
Vol 26 (5) ◽  
pp. 473-479 ◽  
Author(s):  
Patrizio Pezzotti ◽  
Marilena Pappagallo ◽  
Andrew N. Phillips ◽  
Stefano Boros ◽  
Catia Valdarchi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Highly Active
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