The development of metabolic derangements as a result of HIV treatment has been an important area of research since the introduction of zidovudine in the 1980’s. Antiretroviral therapy has intensely evolved in the last three decades, with new drugs gradually incorporated into everyday clinical practice. With the life expectancy of people living with HIV rapidly approaching that of their HIV-negative counterparts, the influence of these antiretrovirals on the development of the components of the metabolic syndrome remains of major interest to clinicians and their patients. In this review, we aimed to discuss the impact of cART on components of the metabolic syndrome, i.e., weight, plasma lipid levels, plasma glucose levels, and blood pressure, describing the influence of cART classes and of individual antiretrovirals. We also aimed to outline the limitations of the research conducted to date and the remaining knowledge gaps in this area.

Endothelial dysfunction is common in HIV-infected patients. In general, none of the analysed factors had an effect on endothelial function but cART had a negative effect on arterial stiffness.

Introduction Delay in HIV diagnosis and consequently late care entry with low CD4 counts remain a major challenge for the control of the HIV/AIDS epidemic. The aim of this study was to analyse the evolution of characteristics of the HIV epidemic in Poland. Methods Cross‐sectional data were collected for 3972 HIV‐infected patients followed up in 14 of 17 Polish HIV treatment centres in the years 2000–2015. Clinical data were analysed and factors associated with late presentation (baseline CD4 count < 350 cells/μL or history of AIDS‐defining illness) and advanced HIV disease (baseline CD4 count < 200 cells/μL or history of AIDS) were identified. Results The majority (57.6%) of patients entered care late, while 35.6% presented with advanced HIV disease. The odds of being linked to care late or with advanced HIV disease increased consistently across age categories, increasing from 2.55 [95% confidence interval (CI) 1.46–4.47] for late presentation and 3.13 (95% CI 1.49–6.58) for advanced disease for the 21–30‐year‐old category to 5.2 (95% CI 1.94–14.04) and 8.15 (95% CI 2.88–23.01), respectively, for individuals > 60 years of age. Increased risks of late entry and advanced HIV disease were also observed for injecting drug users [adjusted odds ratio (aOR) 1.74 (95% CI 1.16–2.60) and 1.55 (95% CI 1.05–2.30), respectively], with lower aOR associated with the men who have sex with men transmission route [aOR 0.3 (95% CI 0.31–0.59) and 0.39 (95% CI 0.29–0.53), respectively]. The frequencies of cases in which patients were linked to care late and with advanced HIV disease decreased over time from 67.6% (2000) to 53.5% (2015) (P < 0.0001) and from 43.5% (2000) to 28.4% (2015) (P = 0.001), respectively. Conclusions Despite improvements over time, most patients diagnosed with HIV infection entered care late, with a third presenting with advanced HIV disease. Late care entry remains common among people who inject drugs and heterosexual groups.

Introduction: Cardiovascular disease is an increasing and leading cause of morbidity and mortality in people living with human immunodeficiency virus (PLHIV) infection. Arterial stiffness is a predictor of endothelial dysfunction in subclinical patients. The aim of this study was to assess which of the laboratory parameters performed during the standard PLHIV medical care visit may be associated with increased arterial stiffness. Material and methods: Thirty HIV-1-infected adult patients (four females and 26 males) were recruited to this study. Endothelial dysfunction and arterial stiffness assessment was performed using the Endo-PAT 2000 device (ITAMAR ®). Baseline pressure waveform obtained by peripheral arterial tonometry (PAT) was used to calculate the augmentation index (AI). AI values were corrected for heart rate using an arbitrarily defined reference heart rate of 75 bpm (AI@75). Results: Our analysis included 30 patients. Men comprised 87% (n = 26), 16 patients (53%) were on combined antiretroviral therapy (cART), 11 patients (36.7%) had undetectable HIV viral load, 15 patients (50%) had active or previous hepatitis C virus (HCV) or hepatitis B virus (HBV) co-infection, and 16 patients (53%) smoked cigarettes. In univariate analysis, only total platelet count and effective cART use influenced arterial stiffness in PLHIV. In multivariate analysis, the variables with confirmed statistical significance were low-density lipoprotein (LDL) (p = 0.040; slope estimate = 6.30 per mmol/l of LDL) and platelet (PLT) count (p = 0.003; slope estimate = 0.13 per 109/l of platelet count). Conclusions: We showed that high LDL concentration and high total platelet count may be an independent risk factor of the subclinical atherosclerotic disease in PLHIV. Moreover, we observed a possible negative influence of cART on arterial stiffness.

Background. The aim of our study was to describe 50 cases of inflammatory bowel disease (IBD) and HIV co-existence that are under medical supervision in Warsaw. Methods. This was a retrospective descriptive study. Fifty HIV-infected patients, diagnosed with IBD during the years 2001–2019, were identified. IBD was diagnosed endoscopically and then confirmed by biopsy. All data was obtained from medical records. Results. All studied patients were male with a median age of 33 years old (range 20–58 years). All, except one, were men who have sex with men (MSM). The median CD4 cell count was 482 cells/µL (range 165–1073 cells/µL). Crohn’s disease (CD) was diagnosed in 7 patients (14%), ulcerative colitis (UC) in 41 patients (82%), and 2 patients (4%) had indeterminate colitis. Forty-nine patients (98%) reported a history of unprotected receptive anal intercourse and different sexual transmitted infections (STIs). Only in 10 patients (20%) were one or more IBD relapses observed. Conclusions. We recommend HIV testing for every MSM with IBD suspicion. Moreover, STIs testing should be performed in every IBD patient with colorectal inflammation, using molecular and serological methods. Persons who reported unprotected receptive anal intercourse seem to have the biggest risk of STI-associated proctitis or proctocolitis mimicking IBD.