Comorbidities and cardiovascular risk factors in an aged cohort of HIV-infected patients on antiretroviral treatment in a Spanish hospital in 2016

Abstract

Comorbidities and risk factors for chronic diseases are very common in HIV-infected patients aged ≥50 years and increase with age, so they should be early considered in the clinical management of these patients. It is important to encourage healthy lifestyles to prevent comorbidities and to control risk factors. Concomitant treatments with ART should be carefully monitored to prevent drug interactions, adverse effects, and patient adherence failures.

Treatment with tenofovir alafenamide fumarate worsens the lipid profile of HIV‐infected patients versus treatment with tenofovir disoproxil fumarate, each coformulated with elvitegravir, cobicistat, and emtricitabine

“…Compared with the general population, people living with HIV have a 1.5‐ to 2‐times increased risk of cardiovascular disease . Fontenla et al estimated that over three quarters had a minimum of one cardiovascular risk factor with dyslipidaemia and smoking being the most frequent ones, similar to what we observed in our study population. Smoking has been found to be associated with a greater risk of myocardial infarction in the HIV‐infected population than in the general population, and nearly 50% of our study population were smokers.…”

“…The availability of these drugs has been a key factor in prolonging the lives of those infected, whose life expectancy has increased from less than 2 years after AIDS illness in the past two decades in patients who receive optimum treatment in the present, approaching that of the general population . However, long‐term use of ART is not free from side effects, and has been related to worsening observed in glucose and lipid values and associated with the risk of developing atherosclerosis, coronary artery disease, and increased incidence of acute myocardial infarction . In addition, the ageing population has brought about an increase in the incidence of comorbidities such as dyslipidaemia, hypertension and diabetes, while there is also a high rate of HIV‐smoking patients .…”

“…Furthermore, HIV infection leads to a series of immunological changes (ie low CD4/CD8 ratio, low T cell proliferative potential, reduced T cell repertoire, increased IL‐6, increased T cell activation, reduced thymus function, reduced response to vaccines) due to the baseline immune activation and persistent chronic inflammation caused by the virus, which can affect a diverse range of organs, thus leading to cardiovascular damage. Taking the above into account, it is clear that cardiovascular disease has now become one of the main causes of death in HIV patients . Therefore, there is a great deal of concern about the cardiovascular health of HIV‐infected individuals in the long term.…”

Social representations of the elderly about HIV/AIDS

“…There is increasing evidence that the prevalence of comorbidities and risk factors for chronic diseases are very common in HIV patients aged 50 years or older and increase with age. Moreover, it is higher in the HIVinfected population when compared to uninfected individuals (1,6) .…”

“…Human Immunodeficiency Virus (HIV) infection has evolved from a fatal condition to a chronic disease condition, leading to increased survival of HIV-infected individuals, resulting in premature aging of this population (1)(2) .…”