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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Widespread use of highly active antiretroviral therapy (HAART) to manage HIV infection is now associated with the development of lipodystrophy syndrome. This syndrome is a combination of such morphologic and metabolic changes as hyperlipidemia, fat redistribution, and insulin resistance. Although many of the long-term effects of HAART have not been fully recognized, it is thought that lipodystrophy syndrome may now contribute to early-onset hypercholesterolemia, heart disease, and diabetes, and may have a negative psychological impact on the individual living with HIV infection.
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PMID:Lipodystrophy syndrome: the morphologic and metabolic effects of antiretroviral therapy in HIV infection. 1553 16

This focus group study examined immigrant Hispanic women's and providers' assumptions about and expectations of healthcare encounters in the context of menopause. Four groups of immigrant women from Central America and one group of healthcare providers were interviewed in Spanish and English, respectively. The women wanted provider-initiated, individualized anticipatory guidance about menopause, acknowledgement of their symptoms, and mainstream medical treatment for disruptive symptoms. Providers believed that menopause was an unimportant health issue for immigrant women and was overshadowed by concerns about high-risk medical problems, such as diabetes, heart disease and HIV prevention. The women expected a healthcare encounter to be patient centered, social, and complete in itself. Providers expected an encounter to be businesslike and one part of multiple visit care. Language and lack of time were barriers cited by all. Dissonance between patient-provider assumptions and expectations around issues of healthcare leads to missed opportunities for care.
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PMID:Agenda dissonance: immigrant Hispanic women's and providers' assumptions and expectations for menopause healthcare. 1560 27

Drug therapy is a vital component of the care required to promote quality of life for individuals who are afflicted with HIV or AIDS. Issues including weight loss and gain, heart disease, insulin resistance, and even increased bone metabolism must be considered when determining appropriate pharmacologic therapy. New complications often arise with new treatments; living longer may not always mean living better. However, it is the responsibility of nurses to promote the best care possible. Management of appropriate drug therapy and the related implications are critical nursing responsibilities in the care of individuals who have HIV or AIDS.
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PMID:Update on antiviral agents for HIV and AIDS. 1573 53

HIV disease today looks very different than it did two decades ago when the first cases were described--at least in developed countries where highly active antiretroviral therapy (HAART) is widely available. Most HIV positive people receiving treatment no longer succumb to opportunistic illnesses (OIs) that take advantage of their ravaged immune systems. Instead, people with HIV now live longer and die from a wide variety of other causes. In other words, a growing number of positive people will die with HIV, but not of HIV. In the HAART era, HIV positive people and their health-care providers must now think about the cumulative impact of chronic HIV infection and the longterm side effects of treatment. In addition, as effective antiretroviral therapy extends the lives of people with HIV, they become prone to conditions that normally occur with greater frequency as people age (such as heart disease, diabetes, and osteoporosis) and progressive conditions that may take decades to cause significant illness or death (such as chronic viral hepatitis). Given the shifts in the types of conditions now seen in people with HIV, it may be time to rethink the definition of AIDS.
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PMID:Mortality trends: toward a new definition of AIDS? 1582 20

There have been conflicting reports in the literature about the protective effect of hemophilia on the occurrence of ischemic heart disease (IHD). Circulatory disease has been reported as the second most common cause of death in persons with hemophilia in the United States. In addition to diabetes and hypertension, high levels of FVIII, as may occur during factor concentrate infusions, may increase IHD risk in this population. To estimate the prevalence of heart disease and examine factors associated with IHD and other heart diseases among persons with hemophilia, we analyzed data collected from the medical records of 3,422 males with hemophilia living in six U.S. states from 1993 to 1998. Heart disease cases were ascertained from among 2,075 persons who were hospitalized at least once during the 6-year period. Of these, 48 were diagnosed with IHD and 106, with other types of heart disease. The age-specific prevalence of IHD ranged from 0.05% in those under 30 years to 15.2% in those 60 years or older. Hospital discharge rates in males with hemophilia with IHD and other types of heart disease were lower compared to rates in age-matched U.S. males. In our cohort, as in the general population, IHD was independently associated with age, hypertension, diabetes, and hyperlipidemia. Other heart diseases were associated with HIV infection, hypertension, hemophilia B, and diabetes. In summary, persons with hemophilia have unique risk factors such as infusion of factor concentrates and infection with HIV that may predispose them to heart disease as their life expectancy increases.
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PMID:Prevalence and risk factors for heart disease among males with hemophilia. 1584 61

In the era of new, potent antiretroviral therapy, much more attention is being given to non-infectious complications of HIV diseases, such as cardiomyopathy, pericardial effusion and pulmonary hypertension (PH). PH diagnosis is based on a mean pulmonary artery pressure of more than 25 mmHg at rest, or more than 30 mmHg with exercise. The incidence of PH is about 0.1% per year among HIV-positive patients, while in the general population it is 1 to 2 cases per million people. The histopathology of HIV-associated PH (HAPH) is similar to that of idiopathic PH, although its pathogenesis is still unclear. In patients with HAPH secondary causes of PH must be ruled out, such as intravenous drug abuse, valvulopathy, congenital heart disease and previous tricuspid endocarditis. The treatment of HAPH is not substantially different from that of idiopathic PH and is essentially based on the use of vasodilators. The Regional Authority of Lazio (Italy) has instituted a Registry for PH in HIV-positive patients; its aims are to evaluate the real incidence and prevalence of primitive and secondary PH among patients with HIV infection, and optimise the management of patients with suspected PH through the definition of a diagnostic algorithm.
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PMID:[Pulmonary hypertension and HIV: implementation of a Regional Registry]. 1588 76

Nanobacteria are suspected to be responsible for a number of diseases, i.e., kidney stones, heart disease, ovarian cancer, peripheral neuropathy, and reduced bone mineral density. Being protected by a mineral shell consisting of apatite, the nanovesicles can enter eukaryotic cells. Depending on the host's stress level, nanobacteria may carry a substantial layer of a protein based slime, instrumental in collecting calcium phosphate from the environment. Calcium phosphate is known to mediate the uptake of nucleic acids by eukaryotic cells. Surprisingly, a pathogenic effect of nanobacteria in HIV can be derived primarily from the trafficking of calcium phosphate in HIV infected cells, performed by primordial proteins. The inescapable conclusion is that nanobacteria could promote genetic diversity in HIV.
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PMID:Primordial proteins and HIV-Part II. 1595 52

Pneumococcal disease is more frequent and more deadly in persons with certain comorbidities. We used 1999 and 2000 data from the Active Bacterial Core surveillance (ABCs) and the National Health Interview Survey (NHIS) to determine rates of invasive pneumococcal disease in healthy adults (> or =18 years old) and in adults with various high-risk conditions. The risks of invasive pneumococcal disease in persons with specific chronic illnesses was compared with that in healthy adults, controlling for age, race, and the other chronic illnesses. Overall incidence rates, in cases/100,000 persons, were 8.8 in healthy adults, 51.4 in adults with diabetes, 62.9 in adults with chronic lung disease, 93.7 in adults with chronic heart disease, and 100.4 in adults who abused alcohol. Among the high-risk groups evaluated, risk was highest in adults with solid cancer (300.4), HIV/AIDS (422.9), and hematological cancer (503.1). Incidence rates increased with advancing age in adults with chronic lung disease, diabetes, and solid cancer. Black adults had higher incidence rates than white adults, both in healthy adults and in adults with chronic illnesses. These data support recommendations to provide pneumococcal vaccine to persons in these at-risk groups and underscore the need for better prevention strategies for immunocompromised persons.
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PMID:The influence of chronic illnesses on the incidence of invasive pneumococcal disease in adults. 1599 50

Increased risk of coronary heart disease has emerged as a long-term concern among HIV-infected patients receiving antiretroviral therapy. HIV-infected patients may have modifiable risk factors for heart disease that are associated with HIV itself, antiretroviral therapy, or factors unrelated to HIV. Dyslipidemia, insulin resistance, and diabetes mellitus are often multifactorial in origin. Patients with lipodystrophy frequently have a constellation of metabolic changes that may predispose them to accelerated atherosclerosis. There is also concern about contributions of chronic inflammation and prothrombotic tendencies in the pathogenesis of coronary heart disease in the HIV-infected population. Several epidemiological studies support an increased relative risk of myocardial infarction in HIV-infected patients on highly active antiretroviral therapy. Although absolute risk appears low in the short term, patients may accrue significant risk over time. Clinicians are advised to assess coronary heart disease risk in HIV-infected patients and to intervene to reduce the impact of modifiable risk factors.
Curr HIV/AIDS Rep 2005 Jun
PMID:Coronary heart disease in HIV-infected patients. 1609 Dec 51

The risks to an HIV-infected person who smokes are dramatically amplified compared with the general population. Smoking has been shown to be an independent risk factor for non-AIDS-related mortality in patients who have HIV, even in patients who receive highly active antiretroviral therapy. It has been independently associated with lower scores for quality-of-life indices, such as general health perception, physical functioning, bodily pain, energy, and cognitive functioning. Over time, considering the significant pathology elicited by tobacco, it is hoped that smoking cessation will help reduce the risks of lung disease, heart disease, and neoplastic conditions in patients who have HIV and increase their general sense of well-being.
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PMID:Tobacco and HIV. 1644 62


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