Management Archives - Page 30 of 56 - HIV Management Guidelines

Pathogenesis of cardiovascular disease in people with HIV infection

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 …

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Inflammation and immune activation as a cause of atherosclerosis in HIV infection

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 …

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Impact of co-infections on cardiovascular disease risk

Co-infections with other viral or bacterial pathogens may increase CVD risk by enhancing HIV-associated immune activation and inflammation or through direct effects on the vascular endothelium. The best studied of these pathogens is cytomegalovirus (CMV), which can activate endothelial cells, promote inflammation and has been associated with serious non-AIDS events, including CVD [52]. As yet, …

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Coronary artery disease outcomes

As discussed above, people with HIV infection experience coronary artery disease at approximately 1.5 times the rates seen in the general population. While initially thought to occur not only at higher rates but also prematurely [55], recent analyses have shown that coronary artery disease occurs at similar ages in people with HIV infection and the …

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References

Samji H, Cescon A, Hogg RS, Modur SP, Althoff KN, Buchacz K, et al. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One 2013; 8(12):e81355. Smith C, Sabin CA, Lundgren JD, Thiebaut R, Weber R, Law M, et al. Factors associated with specific causes of …

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Vaccines in people with HIV infection

Zaal Meher-Homji1, Rachael Purcell2, Jim Buttery2, Michelle Giles1 Department of Infectious Diseases, Alfred Health, VIC Department of Infectious Diseases, Monash Children’s Hospital, VIC Last reviewed: July 2019 Introduction HIV primarily affects CD4+ T cell numbers and function whilst also impacting other components of the immune system (such as macrophages, B cells and NK cells; summarised …

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Diphtheria, tetanus and pertussis vaccine

Corynebacterium diphtheriae and Bordetella pertussis are bacterial upper respiratory tract pathogens, whilst Clostridium tetani is a toxin producing bacteria causing muscle spasm of varied severity. These infections are not considered to be more prevalent or cause more severe disease in HIV affected persons and vaccination should be administered in accordance with routine indications, regardless of …

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Hepatitis B virus vaccine

HBV is transmitted via exposure to infected blood and body fluids, with infection occurring via vertical (perinatal infection from mother to child), sexual, parental or percutaneous routes. 5-10% of people with HIV infection are co-infected with HBV, with long-term sequalae such as cirrhosis and hepatocellular carcinoma occurring with increased frequency in co-infected patients (9). HBV …

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Hepatitis A virus vaccine

Hepatitis A virus (HAV) is transmitted via faecal-oral spread and causes an acute (rarely fulminant) hepatitis. Risk factors include travel to high-risk countries, men who have sex with men (MSM) and injecting drug use. HAV infection does not appear to be associated with worse clinical outcomes in people with HIV, but has been associated with …

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Human papilloma virus vaccine

Human papilloma virus (HPV) is an oncovirus responsible for causing genital warts, as well as cervical, vulval, vaginal, penile, anal and oropharyngeal cancers. Whilst many HPV serotypes have been identified, HPV-6 and HPV-11 are responsible for the majority of noncancerous genital warts and HPV16 and HPV-18 are associated with 60% of HPV associated cancers (15). …

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HIV Management Guide for Clinical Care and ARV Guidelines