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HIV infection, antiretroviral treatment, ageing, and non-AIDS related morbidity

Publisher: 
BMJ
Author: 
Steven G Deeks, professor of medicine, Andrew N Phillips, professor of epidemiology
Date published: 
27 January, 2009
Region: 
United Kingdom

Publication type: 
research

Although mortality in people with HIV infection continues to decrease as treatment improves, it is still higher than in uninfected people.

The risk of non-AIDS related morbidity and mortality—including cardiovascular disease, liver disease, and cancer—is higher in untreated HIV infection than in treated infection.

The incidence of cancer, liver disease, and cardiovascular disease is higher in treated patients than in age matched HIV uninfected people.

Lower CD4+ T cell counts on treatment are associated with increased risk of cancer, liver disease, and perhaps cardiovascular disease.

Treatment improves immunological function, but persistent defects—many of which are seen in advanced ageing—remain.

Inflammation often remains raised during long term antiretroviral treatment; the cause and clinical relevance of this persistent inflammation are unclear.
 

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