Disturbances in glucose metabolism, such as insulin resistance, impaired fasting glucose, impaired glucose tolerance and diabetes mellitus, are amongst the most common endocrine disorders found in treated HIV infection (1, 2). Diabetes and its prediabetic disorders of impaired fasting glucose and impaired glucose tolerance are defined using the American Diabetes Association criteria (3), using either …
Autoimmune thyroid disease is encountered in HIV infection either as a consequence of immune reconstitution related to the use of cART or as a complication of immunomodulatory therapy. Graves’ disease and, less commonly, primary hypothyroidism due to Hashimoto’s thyroiditis may occur as a consequence of aberrant immune tolerance during immune reconstitution, with development of thyroid …
Adrenal insufficiency is uncommon in HIV infection, but can occur as a consequence of infections (HIV-1, cytomegalovirus, toxoplasmosis, mycobacterial infections), neoplastic disease (Kaposi’s sarcoma or other malignancies) or, very rarely, autoimmune disease (Addison’s disease). Adrenal insufficiency is more common in the setting of AIDS, with subnormal stimulated cortisol responses in 26% of tested subjects (41). …
Hypercalcemia is uncommon in HIV infection. Primary hyperparathyroidism with hypercalcemia occurs at the same rate as the non-infected population. If hypercalcaemia is found with low parathyroid hormone (PTH) levels, underlying infection, malignancy or lymphoma require active exclusion. Bone loss, low bone density and osteoporosis are found in HIV wasting syndrome and patients receiving long term …
Disorders of calcium metabolism and osteoporosis Read More »
Male hypogonadism Low androgen levels in HIV-infected men appear relatively common, often in the setting of low or inappropriately normal gonadotrophin levels. The cause of this is not completely understood, however contributors include the usual causes of hypogonadism in men. There appears to be an association with HIV wasting and lipodystrophy (48). Androgen deficiency in …
In considering weight gain in treated HIV infection, it is important to distinguish the “return to health” weight gain that can occur in the setting of cART initiation from the trajectory of undesirable and unhealthy weight gain that reflects modern western living and transition towards obesity. The ‘return to health’ describes the weight gain that …
Samaras K. The burden of diabetes and hyperlipidemia in treated HIV infection and approaches for cardiometabolic care. Current HIV/AIDS reports. 2012; 9:206-17. Samaras K. Prevalence and pathogenesis of diabetes mellitus in HIV-1 infection treated with combined antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes. 2009; 50:499-505. American Diabetes A. (2) Classification and diagnosis of diabetes. …
Janine Trevyllian1, David Nolan2 Department of Infectious Diseases, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC Department of Clinical Immunology, Royal Perth Hospital, Perth, WA Last reviewed: October 2019 Introduction While antiretroviral therapy (ART) has led to dramatic improvements in life expectancy for people with HIV infection [1], there is evidence that …
Atherosclerotic vascular disease in people with HIV infection Read More »
HIV-associated CVD is the result of complex interactions between traditional cardiovascular risk factors, side effects of ART and the chronic inflammation and immune activation associated with long term HIV infection. It is important to acknowledge, however, that the assessment and management of traditional CVD risk factors according to standard guidelines is still the cornerstone of …
Pathogenesis of cardiovascular disease in people with HIV infection Read More »
Atherosclerosis is primarily a disease of inflammation. When the lining of the arterial wall (the endothelium) becomes inflamed, lipid laden foam cells are promoted and drive progression from asymptomatic fatty streaks to pathological atherosclerotic plaques. Foam cells are generated when activated monocytes ingest cholesterol, take up residence in the endothelial wall and then secrete inflammatory …
Inflammation and immune activation as a cause of atherosclerosis in HIV infection Read More »
Developing a sustainable HIV, Viral Hepatitis and Sexual Health Workforce
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