Serious Fatal and Nonfatal Non-AIDS-Defining Illnesses in Europe

Abstract

Non-AIDS events were common in the combination antiretroviral therapy era and associated with considerably mortality. Evidence on the impact of modifying immunodeficiency and lifestyle-related factors on the risk of non-AIDS events in HIV-infected persons is an important but unmet research need.

Increased non‐AIDS mortality among persons with AIDS‐defining events after antiretroviral therapy initiation

“…With this, there has been a shift in distribution of causes of death toward non‐AIDS‐defining events (NADEs) 8, 9, 10, 11, 12. Factors contributing to non‐AIDS mortality include immunodeficiency 13, 14, ART toxicity 15, 16, increasing age 17, 18, 19, 20, 21, 22, and lifestyle factors such as tobacco use and obesity 18, 21, 23. However, chronic inflammation and immune activation produced by chronic HIV infection as well as many AIDS‐defining events (ADEs) are now recognized as significant drivers in the pathogenesis of non‐AIDS‐related deaths 14, 24, 25, 26, 27, 28.…”

Retraso diagnóstico de la infección por VIH

“…Although no clear benefits to starting therapy above 500 cell/ µl have been found due to lack of conclusive studies on the subject 20 , for some years now there has been a growing body of evidence showing reductions in mortality when HAART is started above 500 cell/µl in asymptomatic patients 21,22 . Besides the increase in mortality, DD is associated with an increase in the incidence of opportunistic diseases, both those associated with AIDS and those that are not, such as cardiovascular, kidney and liver diseases and non-AIDS-defined malignant tumours 23 There is sufficient scientific evidence on the factors associated with DD in most regions worldwide. Although the comparability between studies may be partially limited due to different defining criteria for a delayed diagnosis, most of them show a strong association between age and DD.…”

Acute pancreatitis in HIV/AIDS patients: an issue of concern

“…The severe metabolic changes in AIDS patients may play a role in ultrastructural histologic changes found in the pancreas [12] . The hypertriglyceridemia associated with PI use is often severe and difficult to treat, and it may reasonably be expected to lead to an increased risk of hyperlipidemic pancreatitis in the HIV-infected population [8,9] .…”

“…ethanol use and biliary disease), the use of non-cART medications such as pentamidine, corticosteroids, ketoconazole, sulphonamides, metronidazole, isoniazid and opportunistic infections (e.g. cytomegalovirus, cryptosporidiosis, mycobacterial disease) [10][11][12] . In the prehighly active antiretroviral therapy (HAART) era, the reported incidence among HIV-infected patients has been wide-ranging.…”