Management of hypercholesterolemia in individuals living with HIV/AIDS

Ahmed, Musaab; Ahmed, Marium; Mital, Dushyant; Ahmed, Mohamed H.

doi:10.1016/b978-0-323-85857-1.00006-7

Cited by 2 publications

(5 citation statements)

References 115 publications

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“…Therefore, disorders of the hypothalamic–pituitary–adrenal axis resulting in adrenal insufficiency and thyroid dysfunction have also been reported, especially after COVID-19 [ 8 , 62 ]. Other metabolic changes in association with HIV are insulin resistance, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD) and hyperlipidemia (10,14) [ 63 ]. Whether these metabolic changes can have an influence on the bone structure in PLWHIV is an issue that remains to be elucidated.…”

Section: Hiv and Endocrine/metabolic Changes Relating To Impact On Bonesmentioning

confidence: 99%

Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies

et al. 2023

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The developments in Human Immunodeficiency Virus (HIV) treatment and in the care of people living with HIV (PLWHIV) and Acquired Immunodeficiency Syndrome (AIDS) over the last three decades has led to a significant increase in life expectancy, on par with HIV-negative individuals. Aside from the fact that bone fractures tend to occur 10 years earlier than in HIV-negative individuals, HIV is, per se, an independent risk factor for bone fractures. A few available antiretroviral therapies (ARVs) are also linked with osteoporosis, particularly those involving tenofovir disoproxil fumarate (TDF). HIV and hepatitis C (HCV) coinfection is associated with a greater risk of osteoporosis and fracture than HIV monoinfection. Both the Fracture Risk Assessment Tool (FRAX) and measurement of bone mineral density (BMD) via a DEXA scan are routinely used in the assessment of fracture risk in individuals living with HIV, as bone loss is thought to start between the ages of 40 and 50 years old. The main treatment for established osteoporosis involves bisphosphonates. Supplementation with calcium and vitamin D is part of clinical practice of most HIV centers globally. Further research is needed to assess (i) the cut-off age for assessment of osteoporosis, (ii) the utility of anti-osteoporotic agents in PLWHIV and (iii) how concomitant viral infections and COVID-19 in PLWHIV can increase risk of osteoporosis.

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Section: Hiv and Endocrine/metabolic Changes Relating To Impact On Bonesmentioning

confidence: 99%

Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies

et al. 2023

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“…The risk of developing diabetes, hypertension, dyslipidaemia and cardiovascular disease increases with the duration of HIV and cART administration [1,6,8,9]. Unfortunately, the treatment of these conditions can lead to polypharmacy and significantly increase the risk of falls and fracture.…”

Section: Hypertension Diabetes Dyslipidaemia and Cardiovascular Diseasementioning

confidence: 99%

“…Prolonged or regular hypoglycaemia may also enhance the risk of cognitive decline and increase the risk of cardiovascular disease. Diabetes per se can be associated with significant complications such as neuropathy, retinopathy, nephropathy and an elevated risk of developing cardiovascular disease [1,6,8,9]. Therefore, an HIV metabolic clinic is an integral part of HIV services.…”

Section: Hypertension Diabetes Dyslipidaemia and Cardiovascular Diseasementioning

confidence: 99%

“…Therefore, most global HIV-1 treatment guidelines suggest giving integrase strand transfer inhibitors (INSTIs) (such as bictegravir or dolutegravir) as a first-line treatment due to the reduced renal, bone and cardiac toxicities; this reduced toxicity is particularly important in an ageing patient. The nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNR-TIs) also have a greater number of metabolic side effects, e.g., more effect on lipids and glucose compared with INSTIs aids this decision-making process (usually in the form of an MDT), with the latter also having a lower pill burden and fewer drug-drug interactions with other medicines, thus being particularly invaluable for polypharmacy issues [9].…”

Section: Hypertension Diabetes Dyslipidaemia and Cardiovascular Diseasementioning

confidence: 99%

“…[157,158] Disease factors Complex disease with different complex co-morbidities and clinical presentations that necessitate input from different medical specialities. [1,6,7,9,11] Spiritual and religious factors and those related to customs and traditions…”

Section: Patient Factorsmentioning

confidence: 99%

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HIV and an Ageing Population—What Are the Medical, Psychosocial, and Palliative Care Challenges in Healthcare Provisions

Ahmed,

Abu-Median

et al. 2023

Microorganisms

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The continuing increase in patient numbers and improvement in healthcare provisions of HIV services in the UK, alongside the effectiveness of combined antiretroviral therapy (cART), has resulted in increasing numbers of the ageing population among people living with HIV (PLWH). It is expected that geriatricians will need to deal with many older people living with HIV (OPLWH) as life expectancy increases. Therefore, geriatric syndromes in OPLWH will be similar to the normal population, such as falls, cognitive decline, frailty, dementia, hypertension, diabetes and polypharmacy. The increase in the long-term use of cART, diabetes, dyslipidaemia and hypertension may lead to high prevalence of cardiovascular disease (CVD). The treatment of such conditions may lead to polypharmacy and may increase the risk of cART drug–drug interactions. In addition, the risk of developing infection and cancer is high. OPLWH may develop an early onset of low bone mineral density (BMD), osteoporosis and fractures. In this review, we have also provided potential psychosocial aspects of an ageing population with HIV, addressing issues such as depression, stigma, isolation and the need for comprehensive medical and psychosocial care through an interdisciplinary team in a hospital or community setting. OPLWH have a relatively high burden of physical, psychological, and spiritual needs and social difficulties, which require palliative care. The holistic type of palliative care that will improve physical, emotional and psychological wellbeing is discussed in this review.

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Management of hypercholesterolemia in individuals living with HIV/AIDS

Cited by 2 publications

References 115 publications

Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies

Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies

HIV and an Ageing Population—What Are the Medical, Psychosocial, and Palliative Care Challenges in Healthcare Provisions

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