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Life
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Comorbidities and HIV Infection: Barriers in ART-Switch Strategies
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Comorbidities and HIV Infection: Barriers in ART-Switch Strategies

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 12133

Special Issue Editors

Dr. Οlga Tsachouridou

E-Mail Website
Guest Editor
Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
Interests: HIV-1 infection; immunology of infection; COVID-19; bacterial infections; nosocomial infections
Special Issues, Collections and Topics in MDPI journals
Dr. Symeon Metallidis

E-Mail Website
Guest Editor
Infectious Diseases Unit, 1st Internal Medicine Department, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 55436 Thessaloniki, Greece
Interests: HIV-1 infection; COVID-19 infection; nosocomial infections; bacterial infections

Special Issue Information

Dear Colleagues,

Currently, concomitant diseases such as metabolic syndrome and chronic kidney, cardiovascular and bone disease concern HIV physicians in daily practice as the HIV population is aging. The present Special Issue, edited by Dr Olga Tsachouridou and Professor Symeon Metallidis, will incorporate related review papers that reflect clinical implications and ART-switching dilemmas in HIV daily care. This Special Issue will focus on the most frequently arising comorbidities among individuals with HIV, attributed to chronic ART administration or aging and possible implications in ART-switching strategies to minimize the risk of adverse events or reverse established clinical entities.

This Special Issue is now open for submissions. Prospective authors should first send a short abstract or tentative title to the Editorial Office. If the editors deem the topic to be appropriate for inclusion in the Special Issue, the author will be encouraged to submit a full manuscript.

Dr. Οlga Tsachouridou
Dr. Symeon Metallidis
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • depression and anxiety disorders in HIV
  • cardiovascular disease
  • HIV-related bone disease
  • neurocognitive disorders
  • art-switch
  • non-alcoholic fat liver disease
  • dyslipidemia
  • obesity
  • chronic kidney disease in HIV

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Published Papers (5 papers)

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Research

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15 pages, 334 KiB  
Article
Self-Reported Health-Related Quality of Life and Residual Symptoms among Virologically Suppressed People Living with HIV in the Era of Single-Tablet Regimens in Taiwan: A Cross-Sectional Study
by Chien-Yu Cheng, Hsiu-Yin Wang and Chia-Jui Yang
Life 2024, 14(3), 294; https://doi.org/10.3390/life14030294 - 22 Feb 2024
Cited by 1 | Viewed by 1384
Abstract
This study assessed the health-related quality of life (HRQoL) and residual symptom burden among virologically suppressed people living with human immunodeficiency virus (HIV) (PLWH) using a single-tablet regimen in Taiwan. This cross-sectional study administered a self-reported online survey between July and October 2021 [...] Read more.
This study assessed the health-related quality of life (HRQoL) and residual symptom burden among virologically suppressed people living with human immunodeficiency virus (HIV) (PLWH) using a single-tablet regimen in Taiwan. This cross-sectional study administered a self-reported online survey between July and October 2021 to anonymised virologically suppressed PLWH aged ≥20 years. Demographic, HIV-related variables, EuroQol-5-dimensions (EQ-5D), visual analogue scale (VAS), and HIV Symptom Index were analysed. Bivariate analyses were performed to compare HRQoL differences between PLWH and non-PLWH. Among 120 PLWH, 80.9% had HIV diagnosis for <15 years, median antiretroviral therapy (ART) duration of 7.0 years (Q1–Q3:4.0–11.0), and 62.5% had ≥1 comorbidity. The most common comorbidities were depression (26.7%) and hyperlipidaemia (15.8%). About one-fifth of PLWH received constant family support (25.8%) and peer support (21.7%). Married individuals or individuals with higher incomes had significantly better family support status. There was no significant difference across the five dimensions between PLWH and non-PLWH. PLWH perceived being bothered by fatigue/lack of energy (63.3%), sleep difficulties (63.3%), feeling sad/low/unhappy (51.7%), and appearance changes (51.7%). PLWH could achieve similar HRQoL as non-PLWH with stable treatment, highlighting an opportunity to focus on person-centred holistic care beyond HIV, especially on the psychological aspect, for the best possible HRQoL for PLWH. Full article
(This article belongs to the Special Issue Comorbidities and HIV Infection: Barriers in ART-Switch Strategies)

Review

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21 pages, 1145 KiB  
Review
Bone Disease in HIV: Need for Early Diagnosis and Prevention
by Georgios Schinas, Ioannis Schinas, Georgios Ntampanlis, Eleni Polyzou, Charalambos Gogos and Karolina Akinosoglou
Life 2024, 14(4), 522; https://doi.org/10.3390/life14040522 - 17 Apr 2024
Cited by 2 | Viewed by 2111
Abstract
The transformation of HIV into a manageable chronic condition has unveiled new clinical challenges associated with aging-related pathologies, including bone disease. This review explores the intricate relationship between HIV, antiretroviral therapy (ART), and bone disease, highlighting the necessity of early diagnosis and preventative [...] Read more.
The transformation of HIV into a manageable chronic condition has unveiled new clinical challenges associated with aging-related pathologies, including bone disease. This review explores the intricate relationship between HIV, antiretroviral therapy (ART), and bone disease, highlighting the necessity of early diagnosis and preventative strategies to mitigate the increased risk of osteopenia, osteoporosis, and fractures in people living with HIV (PLWHIV). It synthesizes the current literature to elucidate the multifactorial etiology of bone pathology in this population, that includes direct viral effects, chronic immune activation, ART-associated risks, and the impact of traditional risk factors for bone loss. Through a critical examination of modern diagnostic methods, lifestyle modifications, evidence-based preventive actions, and pharmacological treatments, the necessity for comprehensive management is highlighted, along with recommendations for integrated healthcare approaches vital for achieving optimal patient outcomes. By advocating for a proactive, patient-centered, and multidisciplinary strategy, this review proposes a plan to integrate bone health into standard HIV care through active risk identification, vigilant screening, effective preventive measures, tailored treatments, and informed decision-making, in an effort to ultimately enhance the quality of life for PLWHIV. Full article
(This article belongs to the Special Issue Comorbidities and HIV Infection: Barriers in ART-Switch Strategies)
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24 pages, 851 KiB  
Review
Multimodal Approach to Neurocognitive Function in People Living with HIV in the cART Era: A Comprehensive Review
by Charalampos D. Moschopoulos, Evangelia Stanitsa, Konstantinos Protopapas, Dimitra Kavatha, Sokratis G. Papageorgiou, Anastasia Antoniadou and Antonios Papadopoulos
Life 2024, 14(4), 508; https://doi.org/10.3390/life14040508 - 15 Apr 2024
Viewed by 2316
Abstract
Combination antiretroviral treatment (cART) has revolutionized the management of human immunodeficiency virus (HIV) and has markedly improved the disease burden and life expectancy of people living with HIV. HIV enters the central nervous system (CNS) early in the course of infection, establishes latency, [...] Read more.
Combination antiretroviral treatment (cART) has revolutionized the management of human immunodeficiency virus (HIV) and has markedly improved the disease burden and life expectancy of people living with HIV. HIV enters the central nervous system (CNS) early in the course of infection, establishes latency, and produces a pro-inflammatory milieu that may affect cognitive functions, even in the cART era. Whereas severe forms of neurocognitive impairment (NCI) such as HIV-associated dementia have declined over the last decades, milder forms have become more prevalent, are commonly multifactorial, and are associated with comorbidity burdens, mental health, cART neurotoxicity, and ageing. Since 2007, the Frascati criteria have been used to characterize and classify HIV-associated neurocognitive disorders (HAND) into three stages, namely asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND), and HIV-associated dementia (HAD). These criteria are based on a comprehensive neuropsychological assessment that presupposes the availability of validated, demographically adjusted, and normative population data. Novel neuroimaging modalities and biomarkers have been proposed in order to complement NCI assessments, elucidate neuropathogenic mechanisms, and support HIV-associated NCI diagnosis, monitoring, and prognosis. By integrating neuropsychological assessments with biomarkers and neuroimaging into a holistic care approach, clinicians can enhance diagnostic accuracy, prognosis, and patient outcomes. This review interrogates the value of these modes of assessment and proposes a unified approach to NCI diagnosis. Full article
(This article belongs to the Special Issue Comorbidities and HIV Infection: Barriers in ART-Switch Strategies)
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27 pages, 1000 KiB  
Review
Pathophysiology and Clinical Management of Dyslipidemia in People Living with HIV: Sailing through Rough Seas
by Eleni Papantoniou, Konstantinos Arvanitakis, Konstantinos Markakis, Stavros P. Papadakos, Olga Tsachouridou, Djordje S. Popovic, Georgios Germanidis, Theocharis Koufakis and Kalliopi Kotsa
Life 2024, 14(4), 449; https://doi.org/10.3390/life14040449 - 28 Mar 2024
Cited by 1 | Viewed by 3649
Abstract
Infections with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) represent one of the greatest health burdens worldwide. The complex pathophysiological pathways that link highly active antiretroviral therapy (HAART) and HIV infection per se with dyslipidemia make the management of lipid [...] Read more.
Infections with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) represent one of the greatest health burdens worldwide. The complex pathophysiological pathways that link highly active antiretroviral therapy (HAART) and HIV infection per se with dyslipidemia make the management of lipid disorders and the subsequent increase in cardiovascular risk essential for the treatment of people living with HIV (PLHIV). Amongst HAART regimens, darunavir and atazanavir, tenofovir disoproxil fumarate, nevirapine, rilpivirine, and especially integrase inhibitors have demonstrated the most favorable lipid profile, emerging as sustainable options in HAART substitution. To this day, statins remain the cornerstone pharmacotherapy for dyslipidemia in PLHIV, although important drug–drug interactions with different HAART agents should be taken into account upon treatment initiation. For those intolerant or not meeting therapeutic goals, the addition of ezetimibe, PCSK9, bempedoic acid, fibrates, or fish oils should also be considered. This review summarizes the current literature on the multifactorial etiology and intricate pathophysiology of hyperlipidemia in PLHIV, with an emphasis on the role of different HAART agents, while also providing valuable insights into potential switching strategies and therapeutic options. Full article
(This article belongs to the Special Issue Comorbidities and HIV Infection: Barriers in ART-Switch Strategies)
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Other

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11 pages, 5204 KiB  
Case Report
Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature
by Ioannis Kofotolios, Stathis Tsiakas, Chrysanthi Skalioti, Eleni Kapsia, George Liapis and Smaragdi Marinaki
Life 2023, 13(3), 641; https://doi.org/10.3390/life13030641 - 25 Feb 2023
Cited by 2 | Viewed by 2038
Abstract
Renal complications of HIV infection are common and histologically diverse. Besides HIV-associated nephropathy, which is the most well-defined glomerular disorder, immune-complex-mediated glomerulonephritis (HIVICK) is also encountered in the setting of HIV infection and may occasionally present with “lupus-like” features by light microscopy and [...] Read more.
Renal complications of HIV infection are common and histologically diverse. Besides HIV-associated nephropathy, which is the most well-defined glomerular disorder, immune-complex-mediated glomerulonephritis (HIVICK) is also encountered in the setting of HIV infection and may occasionally present with “lupus-like” features by light microscopy and immunofluorescence. Management of HIVICK remains controversial and mainly focuses on HIV viremia suppression with combined antiretroviral therapy. Immunosuppressive therapy may be used in order to mitigate the renal inflammation induced by the immune complex deposition. Data regarding the use of immunosuppressants in HIVICK are very limited, mostly including corticosteroids and mycophenolate acid analogues. Herein, we present the case of a 40-year-old HIV-infected Caucasian man with nephrotic syndrome, renal impairment, and a “lupus-like” membranous pattern in the kidney biopsy, who achieved a partial response of his proteinuria with a tacrolimus-based regimen in combination with antiretroviral therapy. Full article
(This article belongs to the Special Issue Comorbidities and HIV Infection: Barriers in ART-Switch Strategies)
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