HIV-negative persons receiving Pre-Exposure Prophylaxis (PrEP) PrEP is recommended in HIV-negative persons who are at high-risk for HIV infection.13 The recommended regimen for PrEP involves a fixed-dose combination of oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF). Given the association of TDF with bone loss, concern exists about bone toxicity in those receiving PrEP. A sub-study from an …
The Royal Australian College of General Practitioners and Osteoporosis Australia. Osteoporosis prevention, diagnosis and management in postmenopausal women and men over 50 years of age, 2nd edn. East Melbourne, Vic: RACGP,2017. World Health Organisation. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. Technical Report Series, …
Katherine Samaras1,2,3 St Vincent’s Clinical School, University of New South Wales, Sydney, NSW Department of Endocrinology, St Vincent’s Hospital, Sydney, NSW. Garvan Institute of Medical Research, Sydney, NSW Last reviewed: November 2019 Introduction Endocrine conditions occur commonly in HIV infection, due to specific effects of the virus, HIV-related disease, the effects of reconstitution of the …
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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 …
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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. …