Life Of HIV-infected Patients Research Articles

Strategies to overcome HIV drug resistance-current and future perspectives.

The availability of combined antiretroviral therapy (cART) has revolutionized the course of HIV infection, suppressing HIV viremia, restoring the immune system, and improving the quality of life of HIV infected patients. However, the emergence of drug resistant and multidrug resistant strains remains an important contributor to cART failure, associated with a higher risk of HIV-disease progression and mortality. According to the latest WHO HIV Drug Resistance Report, the prevalence of acquired and transmitted HIV drug resistance in ART naive individuals has exponentially increased in the recent years, being an important obstacle in ending HIV-1 epidemic as a public health threat by 2030. The prevalence of three and four-class resistance is estimated to range from 5 to 10% in Europe and less than 3% in North America. The new drug development strategies are focused on improved safety and resistance profile within the existing antiretroviral classes, discovery of drugs with novel mechanisms of action (e.g., attachment/post-attachment inhibitors, capsid inhibitors, maturation inhibitors, nucleoside reverse transcriptase translocation inhibitors), combination therapies with improved adherence, and treatment simplification with infrequent dosing. This review highlight the current progress in the management of salvage therapy for patients with multidrug-resistant HIV-1 infection, discussing the recently approved and under development antiretroviral agents, as well as the new drug targets that are providing a new avenue for the development of therapeutic interventions in HIV infection.

Relationship between CD4 count, viral load, and quality of life in HIV-infected patients on HAART attending a primary healthcare setting in South Africa

Relationship between CD4 count, viral load, and quality of life in HIV-infected patients on HAART attending a primary healthcare setting in South Africa

New 2-alkylthio-1-benzylimidazole-5-carboxylic acid derivatives targeting gp41: design, synthesis and in vitro anti-HIV activity evaluation.

Background Although current available medications have increased the quality of life in HIV-infected patients, there are still some shortcomings in HIV treatment arising from viral resistance, drug side effects and high cost of medication. Therefore, there is an urgent need for some suitable HIV inhibitors with different mechanisms of action. Gp41, located on the HIV cell surface, plays an important role in the fusion of viral and host cell membranes. With the same structure in different HIV strains, gp41 seems to be a promising target for developing novel HIV fusion inhibitors. Objective Based on the essential structural elements of gp41 inhibitors, two series of compounds were prepared and their inhibitory effect on HIV cell growth was investigated. Compared to the known small-molecule gp41 inhibitors, 2-Alkylthio-1-benzylimidazole-5-carboxylic acid (series I) and (E)-4-{[5-(((1-benzyl-1H-1,2,3-triazol-4-yl)methoxyimino)methyl)-2-(alkylthio)-1H-imidazol-1-yl]methyl}benzoic acid derivatives (series II) had more flexible skeleton with extra moieties interacting with the gp41 key residues. Method In silico drug design approaches including molecular docking and molecular dynamics simulations were employed to design these novel compounds prior to preparation. The designed compounds exhibited proper chemical interactions and stable complexes with gp41. Then, the selected candidates were efficiently synthesized, and their anti-HIV-1 and anti-HIV-2 activities, as well as their cellular cytotoxicity in MT-4 cells were determined. Results None of the compounds belonging to the series I were active against HIV-1 and HIV-2 replication in cell cultures, and most of the compounds in series II exhibited significant cytotoxicity against MT-4 cells in low micro molar concentrations. Conclusion The smaller molecular structures of the compounds in series I might be responsible for their poor anti-HIV effects. The high toxicity of the series II compounds on the host cell makes it impossible to assess their anti-HIV activities.

Effects of cognitive and behavioral intervention on self-management, self-efficacy and quality of life in HIV infection cases receiving anti-retroviral treatment

Objective: To evaluate the effects of cognitive and behavioral intervention on self-management, self-efficacy and quality of life of HIV infection cases. Methods: A total of 200 HIV infection cases visiting STD/AIDS clinic at Beijing Youan Hospital from January to December of 2018 were recruited in this study. They were divided into cognitive and behavioral intervention group and control group based on the method of random number table. Both groups received routine outpatient care. The intervention group received cognitive and behavioral intervention in addition to routine outpatient care. The self-management scale, self-efficacy scale and life quality scale were used before and after the intervention for 3 months respectively to evaluate the self-management, self-efficacy and quality of life of the intervention group, and the differences between the two groups were analyzed. Results: There were 100 cases in each group, 69.5% (139/200) of them were males, and 72.0% (144/200) were infected by sexual transmission. After cognitive and behavioral intervention, the intervention group had higher scores of self-management (119.52±20.94 vs. 80.76±27.35), self-efficacy (30.88±5.73 vs. 21.84±7.56) and quality of life (73.51±9.44 vs. 66.91±11.53) compared with the scores before intervention. The self-management (119.52±20.94), self-efficacy (30.88±5.73) and quality of life (73.51±9.44) of the intervention group had higher scores than those of the control group (101.99±21.36), (27.04±6.45), (69.99±10.65) (P<0.05). Conclusion: Cognitive and behavioral intervention can significantly improve the self-management, self-efficacy and quality of life of HIV infected patients, which has positive clinical significance.

Symptoms and quality of life in HIV-infected patients with benign prostatic hyperplasia are improved by the consumption of a newly developed whole tomato-based food supplement. A phase II prospective, randomized double-blinded, placebo-controlled study

Carotenoid rich diets have proven to be beneficial in decreasing urinary symptoms of benign prostatic hyperplasia (BHP) and cardiovascular risk factors, especially following the consumption of whole tomato, the major source of dietary lycopene. Here, we describe the results of a phase II prospective, randomized double-blinded, placebo-controlled study undertaken to determine the efficacy and safety of a novel whole tomato-based food supplement (WTFS) containing lycopene in highly bioavailable form in 31 HIV+ patients with proved BPH. The consecutive enrolled patients received daily, for 12 weeks, 5 g of WTFS or placebo. The study demonstrates that WTFS consumption is associated with a statistically significant improvement of all BPH symptoms and quality of life, free/total prostate specific antigen ratio, and diastolic blood pressure, with a trend in interleukin 6 level reduction. WTFS may offer a side effect-free food supplement for the management of BPH in HIV+ patients.

Knowledge, Attitudes, and Practices Regarding Cervical Cancer Screening among HIV-infected Women at Srinagarind Hospital: A Cross-Sectional Study.

Introduction:In recent years, the lives of HIV-infected patients in Thailand have improved significantly due to continuous advances in treatment. However, the rate of cancer related to HIV infection (especially cervical cancer) is likely to increase. Although the World Health Organization (WHO) recommends Papanicolaou testing in all HIV-infected women, few of these patients receive this kind of screening in Thailand. Therefore, we conducted this study to evaluate the knowledge, attitudes, and practices of these patients with regard to cervical cancer screening. Materials and Methods:This cross-sectional study was conducted in HIV-infected women aged 18-65 years from April to November 2019 via a self-administered cervical cancer screening questionnaire, which consisted of four parts: demographic data, knowledge, attitudes, and practices. Results:Three hundred HIV-infected women were recruited. Most of the participants had good attitudes toward screening and practiced adequate screening (75.3% and 71.3%, respectively). However, only 62 participants (20.7%) demonstrated adequate knowledge. The crucial factors that were associated with adequate screening practice were age 40-49 years-old (AOR =3.26, 95%CI=1.02-10.37), CD4 cell count (AOR = 3.41, 95%CI = 1.29-8.99), having been advised about cervical cancer screening (AOR= 6.23, 95%CI 1.84-21.07), and attitude toward screening (AOR= 5.7, 95%CI = 2.23-14.55). The major reasons for not undergoing screening were embarrassment (41.86%), lack of symptoms (41.86%), fear of the results (36.04%), and fear of pain (36.04%). Conclusion:The reasons for inadequate testing were disregard and misconceptions about the procedure. To prevent invasive cervical lesions in HIV-infected women, health care providers should inform these patients about the importance of regular cervical cancer screening.

The effect of concomitant fibromyalgia in HIV infected patients receiving antiretroviral therapy: a prospective cross-sectional study

BackgroundHIV infected patients receiving antiretroviral therapy (ART) have extensive musculoskeletal system involvement. Arthralgia and myalgia are the most common forms. Fibromyalgia Syndrome (FMS) is a chronic pain syndrome of the musculoskeletal system characterized by diffuse pain including arthralgia and myalgia. These overlapping symptoms are suggested the relationship between HIV and FMS. The primary purpose of this study was to determine the prevalence of FMS in HIV/AIDS patients. The secondary objective was to investigate the effects of FMS on functional status, depression, fatigue, sleep pattern and quality of life.MethodsA total of 225 HIV infected patients who were receiving ART were included in this cross-sectional prospective study. The demographic data of the participants, CD4 T-lymphocyte count (cells/mm3), viral load (> 40 copy/ml), and ART regimens were recorded. FMS diagnosis was based on 2016 revision of diagnostic criteria. All patients completed the following questionnaires: Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), and SF-36 scale.ResultsFMS was found in 20% of the HIV infected patients (n = 45). The mean duration of disease was 4.74 ± 4.42 years; it was significantly longer in patients with FMS (p = 0.007). The median CD4 T-lymphocyte count was found to be 616.00 ± 303.91 cells/mm3, and it was significantly higher in patients without FMS (p = 0.06). No statistically significant difference was found between the two groups according to the drug regimens used. A statistically significant difference was found in FIQ, BDI, PSQI, FSS and all subgroups of the SF-36 scale between the patients with and without FMS (p = 0.001).ConclusionsA slightly higher frequency of FMS was determined in HIV infected patients receiving ART compared to previous studies. It was shown that presence of FMS negatively affected the function, depression, fatigue, sleep, and quality of life. Detection of FMS may decrease depression, fatigue, and sleep disorders and increase the quality of life in HIV infected patients. FMS should be distinguished correctly for an accurate treatment management of HIV and for increasing ART compliance.

Changes health-related quality of life in HIV-infected patients following initiation of antiretroviral therapy: a longitudinal study

BackgroundSeveral tools have been developed to evaluate HIV health-related quality of life (HRQoL) during and after antiretroviral therapy (ART). Few longitudinal studies evaluated the effect of ART on the quality of life of HIV patients. ObjectiveTo evaluate changes in HRQoL in HIV-infected individuals one year after initiating ART. MethodsA prospective study was conducted from May 2016 to July 2018. Data on clinical and sociodemographic characteristics of 91 HIV-infected patients were collected prior to initiation of ART and one year thereafter. Demographic and clinical data were collected and the questionnaires 36-item Short Form Health Survey (SF-36) and HIV/AIDS-targeted quality of life (HAT-QoL) were administered in both periods. Asymptomatic individuals, aged ≥18 years, were included in the study. Patients who discontinued treatment were excluded. The association between predictors of physical and mental HRQoL was analyzed by multiple linear regression analysis. ResultsPatients were predominantly male (78.0%), mean age 35.3 ± 10.7 years, with no stable relationship (80.2%), and no comorbidities (73.6%). Most of the SF-36 domains improved after one year, particularly Physical Function (p = 0.0001), General Health (p = 0.0001), Social Functioning (p = 0.0001), Mental Health (p = 0.001), and Mental Component Summary (p = 0.004). HAT-QoL domains improved in the Overall Function (p = 0.0001), Life Satisfaction (p = 0.0001), Provider Trust (p = 0.001), and Sexual Function (p = 0.0001) domains. Sex (p = 0.032), age (p = 0.001), income (p = 0.007), and stable relationship (p = 0.004) were good predictors of the Physical Component Summary. Sex (p = 0.002) and stable relationship (p = 0.038) were good predictors of the Mental Component Summary. SF-36 and HAT-QoL scales presented strong correlations, except for Medication Concerns (0.15–0.37), HIV Mastery (0.18–0.38), Disclosure Worries (−0.15 to 0.07), and Provider Trust (−0.07 to 0.15). ConclusionsART improved HRQoL after one year of use. The HAT-QoL and SF-36 correlated well and are good tools to evaluate HRQoL in HIV-infected patients on ART.

Quality of life and handgrip strength of HIV patients diagnosed with neurotoxoplasmosis

Abstract HIV / AIDS epidemic continues to be a major public health problem, and when there is poor adherence to treatment, patients become susceptible to other infections such as toxoplasmosis. The aim of this study was to evaluate the handgrip strength and quality of life of HIV infected patients diagnosed with neurotoxoplasmosis. A cross-sectional study was conducted with 40 HIV-infected patients, with and without diagnosis of neuroxoplasmosis.Sociodemographic and clinical profile information was collected, and handgrip strength and quality of life were evaluated. Almost all patients of both groups used antiretroviral therapy. In the handgrip strength evaluation, no statistical difference was observed for the right and left hand between groups with and without neurotoxoplasmosis (p&gt; 0.05). However, the classifica-1 Federal University of Pará. Gradution of inadequate handgrip strength in the neurotoxoplasmosis group was significantly higher.ate Program in Tropical Diseases. In the quality of life domain, it was observed that financial concern had lower scores in the Belém, PA. Brazil. group with neurotoxoplasmosis (p = 0.0379). It was observed that neurotoxoplasmosis showedno association with epidemiological, clinical, handgrip strength and quality of life variables.2 State University of Pará. Center However, patients with neurotoxoplasmosis showed a trend towards lower muscle strength.

580. Key Factors for Treatment Changes Within 1 Year After Starting ART in the German ClinSurv Cohort: Between 2005 and 2014

BackgroundInitiation of combined antiretroviral therapy (cART) has markedly increased survival and quality of life in HIV-infected patients. With the advent of new treatment options, including an increasing number of single-tablets, the durability of first-line ART regimes is developing.MethodsWe used data from the prospective multicenter German Clinical Surveillance of HIV Disease (ClinSurv) cohort of the Robert-Koch-Institute. Time to event was calculated as time between initiation of first-line cART and therapy change. We used a Cox model to assess predictors of treatment change 1 year after starting cART.ResultsWe included 6,894 patients who initiated ART between 2005 and 2014. The sample population was predominantly men (79%) with German origin (69.8%), of which 49.6% were reporting sex with men (MSM) as main risk factor. Median age (IQR) was 38 (31–46) years. The most frequently treatment combinations were 2NRTI/PIr (48.1%) and 2NRTI/1NNRTI (42.2%), 2NRTI/1II (5.2%). 22.6% patients changed their first-line treatment within 1 year. Median (IQR) length between first intake and stop of the regime was 105 (35–214) days, which did not change significantly between 2005 (108; 38–217) and 2014 (128; 74–200) (P = 0.28). Most common documented causes were side effects of drugs 418 (44.0%) and non-adherence 173 (18.2%). In the Cox model (Figure 1), we identified numerous covariates associated with discontinuation of the first-line regime. A 2NRTI/1NNRTI regime was associated with higher rates (hazard ratio [HR] 1.28, 95% CI 1.06–1.55) and a 2NRTI/1II regime with lower rates (HR 0.34, 95% CI 0.23–0.51) of treatment modification (ref.: 2NRTI/1PIr). The HR increased markedly with the amount of daily-administered tablets from HR 2.15, 95% CI 1.48–3.11 (2–3 tablets) to HR 3.98, 95% CI 2.16–7.31 (10 tablets) (ref.: one tablet). We observed an association with a baseline viral load (VL) of >100 copies/mL (HR 0.65, 95% CI 0.53–0.81) and >100.000 copies/mL (HR 0.68, 95% CI 0.54–0.85) (ref.: VL > 1 Mio. copies/mL).ConclusionOur analysis revealed, that side effects of drugs, the number of tablets per day and the VL at baseline are significantly associated with treatment change within the first year. A first-line regime with 2NRTI/1II seems to improve the adherence to the initial regime significantly. Disclosures All authors: No reported disclosures.

Nutritional status and quality of life in HIV-infected patients

Rationale: Though some studies have looked at the impact nutritional status has on quality of life (QoL) in patients with chronic diseases, few have studied this in HIV-infected individuals.

Pharmacist Intervention and Quality of Life of HIV-Infected Patients in Nigeria

Assessment of quality of life of HIV-infected patients on combined antiretroviral therapy (cART) is imperative in the management of the disease. This study was done to assess the quality of life (QOL) of HIV-infected patients on cART before and after the pharmacist intervention. Consented HIV diagnosed outpatients in a tertiary health care facility in Benin City that met inclusion criteria were consecutively enrolled into the study. The QOL of these patients was determined in the four domains of WHOQOLHIV BREF instrument. The raw scores for each domain in the WHOQOL-HIV BREF were calculated by adding values of single items. The scores were computed on the scale of 0 to 100. One way ANOVA and Student t-test were used to compare means. At baseline, mean QOL values were below 73. The lowest values were in the social domain and the best values in the physical domain. The QOL values increased steadily over the period of interventions with the highest mean QOL of 93.7 in the physical domain. The improvement in QOL was significant at 6 and 9 months following interventions (p &lt; 0.001). The values obtained are expressed in percentage. There was no statistically significant difference between male and female patients on cART in all domains of QOL following the intervention. Patients on Tenofovir + Emtricitabine + Efavirenz combination therapy had significantly higher scores in all the domains of QOL as compared with other drug combinations used in the management of the patients. The only educational level of the patients was significantly associated with the patients’ QOL. The intervention in this prospective study was a success, as it led to increasing in QOL for the patients on cART from the baseline level to the end of the 9th month.Bangladesh Pharmaceutical Journal 20(2): 132-138, 2017

Pattern of cutaneous manifestations among HIV patients of a Tertiary Care Teaching Hospital

Introduction: The most recent data from UNAIDS, about 35 million people are living with HIV infection worldwide. Cutaneous disorders occur more frequently as HIV infection advances and immune function deteriorates; however, they are common and of various types throughout the course of HIV disease. Taking cutaneous disorders into consideration for case management is essential to improve quality of life for HIVinfected patients. Materials and method: The current record based study was conducted at the tertiary care teaching hospital of Kasturba medical College, Mangalore. The records of all the HIV positive patients who visited dermatology clinic, were retrieved from the record section of the hospital. The information pertaining to the demographic characteristics, mode of transmission of HIV and cutaneous manifestations were obtained from the case records.. Data was entered and analyzed using SPSS Results: About half (n=67, 51.5%) the patients were in the age group of 26-35 years, and one quarter (n=30, 23.1%) were between 36 and 45 years old. About 86.9% (n=113) of patients acquired HIV through the sexual exposure. Conclusion: Oropharyngeal candidiasis was the most common dermatological manifestations observed among the participants in the current study

Reliability and validity of Persian version of Medical Outcome Study-HIV health survey in Iranian people living with HIV

ObjectiveTo evaluate the psychometric properties of the Persian version of the medical outcome study human immunodeficiency virus (MOS-HIV) health survey among people living with HIV or acquired immune deficiency syndrome (HIV/AIDS) in Iran is our main goal in this study. MethodsThe MOS-HIV questionnaire was translated into Persian using backward translation and the Persian version was filled by 100 HIV infected patients. Reliability of the questionnaire was estimated using Cronbach's alpha coefficient for the total questionnaire and for each dimension. Convergent, discriminant and construct validity were performed. Comparisons were performed between the subscales of the questionnaire in Iran and some other countries with t-test. ResultsThe overall Cronbach's alpha in this study was 0.90 and the range of this coefficient was from 0.71 to 0.86 across the subscales with two exceptions, general health perception and role functioning, which were at 0.65 and 0.61. Convergent and discriminant validity were excellent in all domains. The two factor confirmatory factor analysis showed a good fit based on standardized estimates of factor loading, incremental and absolute fit indices. ConclusionThe Persian version of the MOS-HIV had good reliability and validity in measuring health related quality of life in people living with HIV in Iran. Furthermore, quality of life for HIV infected patients was very low in comparing with the people in some other countries.

Health-related quality of life of HIV infected adults with and without Visceral Leishmaniasis in Northwest Ethiopia

BackgroundHealth-related quality of life (HRQoL) is an important outcome measure among HIV infected patients receiving antiretroviral therapy (ART). When HIV infected patients coinfected with Visceral Leishmaniasis (VL) the problem become severe because VL accelerates HIV replication and disease progression. The impact of VL on the quality of life of HIV infected patients has not been studied. In this study in Ethiopia, we compared the quality of life of HIV infected patients with and without VL.MethodsA cross-sectional study was conducted from October 2015 to September 2016 in selected health centers and hospitals, in Northwest Ethiopia. Data on quality of life was collected by trained nurses. The instrument used to collect the data was the short Amharic version of the World Health Organization Quality of Life for HIV clients (WHOQoL-HIV). Depression was assessed using the validated version of Kessler scale. Data was entered and analyzed using SPSS version 20. Descriptive statistics, bivariate and multivariate linear regression model was used to summarize the results.ResultsA total of 590 study participants were included in the study with response rate of 95%. Of the 590 patients included in our study 125 (21%) were HIV-VL coinfection. HIV-VL coinfected patients had a lower quality of life in all the domains as compared to HIV patients without VL. Depression was consistently and strongly associated with all the quality of life domains of both groups. Also, in HIV infected patients a longer duration in ART was associated with higher HRQoL domains except for the spiritual and level of independence domains. With regard to HIV-VL coinfected patients, a longer duration in ART was associated with psychological, spiritual and level of independence domains of HRQoL. Demographics, clinical, and treatment characteristics resulted few significant associations with HRQoL domains of both groups.ConclusionHIV-VL coinfected patients had a poor quality of life in all the domains of the WHOQoL-HIV instrument. Depression, duration of ART and education were strongly associated with the quality of life. Depression should be targeted for intervention to improve the quality of life.

Nutritional status and quality of life in HIV-infected patients.

Nutritional status and the progression of the human immunodeficiency virus (HIV) are interlinked; though some studies have looked at the impact nutritional status has on quality of life (QoL) in patients with chronic diseases, few have studied this in HIV-infected individuals. To investigate the relationship between nutritional status and QoL in adults with a recent HIV diagnosis. Individuals with an HIV diagnosis performed in the fourteen months prior to a medical visit to one of Lisbon's central hospitals were eligible. Nutritional status was assessed by anthropometry, body composition analysis, and dietary intake. QoL was assessed using the WHOQOLHIV-BREF questionnaire. Sociodemographic and clinical data were also considered. Fifty-one subjects were eligible for enrolment; the majority were male, Caucasian, employed, single, and under highly active antiretroviral therapy (HAART). Lower QoL scores were observed in subjects with inadequate energy intakes, reported weight loss, and a high waist circumference in bivariate analysis (p < 0.05); the same variables influenced QoL negatively after adjusting for confounders in multivariate analysis (p < 0.05). Various sociodemographic characteristics such as level of education, age, gender, and current health problems also predicted QoL significantly (p < 0.05). Various aspects of nutritional status were responsible for the variations observed in QoL, suggesting a potential for nutritional intervention in improving QoL in this population.

Effects of massage therapy on anxiety, depression, hyperventilation and quality of life in HIV infected patients: A randomized controlled trial

IntroductionHIV infection is often preceded or accompanied by psychiatric comorbidities. These disorders improve with complementary therapies. The aim of this study was to measure the effect of massage therapy on anxiety, depression, hyperventilation and quality of life in HIV infected patients. MethodAdult HIV-infected patients were randomized (n = 29) in massage therapy group (one hour a week during four weeks) and control group. Anxiety and depression (HADS-A and HADS-D), hyperventilation (Nijmegen questionnaire) and quality of life (WHOQOL-HIV) were evaluated at inclusion and after 4 weeks. ResultsAt inclusion, 51% and 17% of the patients had a positive HADS-A and HADS-D score respectively. Two facets from WHOQOL-HIV (“Home environment” and “Death and dying” (p = 0.04)) were different between groups. After the four week massage therapy, a significant improvement was observed only for Nijmegen questionnaire (p = 0.01) and HADS-A (p = 0.04) contrarily to WHOQOL-HIV and HADS-D. Domains of the WHOQOL-HIV did not improve following the massage therapy. Only “Pain and discomfort” facet improved after massage therapy (p = 0.04). ConclusionThis study highlights the positive impact of a four week massage therapy on anxiety and hyperventilation in HIV infected patients. However, neither benefit of this program was observed on depression and quality of life.

ИССЛЕДОВАНИЕ КАЧЕСТВА ЖИЗНИ ВИЧ-ИНФИЦИРОВАННЫХ БОЛЬНЫХ С ЗАБОЛЕВАНИЯМИ ОРГАНА ЗРЕНИЯ

The importance and the need to establish standards for the quality of life for HIV-infected patients with eye diseases were proved. The scheme of follow-up of ophthalmic patients with HIV infection was created; it allows identifying the relationship between the organ of vision and quality of life of infected patients. An algorithm of examination of patients with a combination of HIV infection and ophthalmological pathology was developed. It is proved that with the growth of the severity of internal organ involvement in HIV-infected patients a decrease in quality of life occurs pro rata, par-ticularly in patients in 3–4th stages of HIV infection associated with atrophy of the optic nerve, uveitis, retinitis. It was established that on the background of an effective anti-viral and vascular therapy of HIV-infected patients there is a positive dynamics of vision in patients with retinal angiopathies.

Impact of Education for Adherence to Therapy Based on Health Promotion Model on the Quality of Life in HIV-infected Patients

Impact of Education for Adherence to Therapy Based on Health Promotion Model on the Quality of Life in HIV-infected Patients

What happens to cardiovascular system behind the undetectable level of HIV viremia?

Despite the combined antiretroviral therapy has improved the length and quality of life of HIV infected patients, the survival of these patients is always decreased compared with the general population. This is the consequence of non-infectious illnesses including cardio vascular diseases. In fact large studies have indicated an increased risk of coronary atherosclerotic disease, myocardial infarction even in HIV patients on cART. In HIV infected patients several factors may contribute to the pathogenesis of cardiovascular problems: life-style, metabolic parameters, genetic predisposition, viral factors, immune activation, chronic inflammation and side effects of antiretroviral therapy. The same factors may also contribute to complicate the clinical management of these patients. Therefore, treatment of these non-infectious illnesses in HIV infected population is an emerging challenge for physicians. The purpose of this review is to focus on the new insights in non AIDS-related cardiovascular diseases in patients with suppressed HIV viremia.